R-rated movies, bedroom televisions, and initiation of smoking by white and black adolescents.

Objective: To test movie exposure and television use as predictors of smoking initiation among white and black adolescents who had never smoked cigarettes.

Design: Survey research using audio computer-assisted self-interviews at baseline and at 2-year follow-up (2002-2004).

Setting: Participants' homes located in central North Carolina.

Participants: A sample of 735 12- to 14-year-old adolescents drawn from 14 public middle schools.

Main Exposure: Frequency of exposure to movies rated R, PG-13, PG, or G; frequency, location, and parental oversight of television viewing.

Main Outcome Measure: Initiation of smoking, indicated by the first occasion of puffing on a cigarette.

Results: Among white adolescents, high relative exposure to R-rated movies predicted a significantly greater likelihood of smoking initiation at follow-up, and private access to television during early adolescence, indicated by having a bedroom television, was also a significant independent predictor of smoking initiation at follow-up. No significant associations were observed between any movie-exposure or television-use variables and likelihood of smoking among black adolescents.

Conclusions: Indicators of risky media use were associated with a significantly greater likelihood of smoking for white but not for black adolescents. These results diverge strongly from past results, which have indicated that all adolescents, regardless of race or place of residence, have a higher risk of smoking initiation as their exposure to movie smoking increases. Research is needed to identify the antecedents of risky media use and to understand how audience attributes, including race and other factors, moderate the effects of risky media use on health-related behaviors.