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Out smoking on the big screen: tobacco use in LGBT movies, 2000–2011

Objective Lesbian, gay, bisexual and transgender (LGBT) people have significantly higher smoking prevalence than heterosexual people in the USA. The reasons for this disparity remain unclear. Tobacco use in movies has a substantial influence on tobacco use behaviours, particularly among youth. Yet, no research has examined tobacco use in movies for LGBT audiences or containing LGBT characters. Methods We identified 81 US movies from 2000 to 2011 with a theatre release and with LGBT themes or characters. We then selected a random sample of these movies (n=45) for quantitative content analysis to examine the proportion of movies with depictions of tobacco use and the number of occurrences of tobacco use. Results Tobacco use was depicted in 87% (95% CI 80% to 94%) of movies with an average of four occurrences of tobacco use per hour (95% CI 3 to 5). Only 15% (95% CI 8% to 23%) of movies and 3% of all depictions of tobacco use conveyed any harms of tobacco use. Conclusions Viewers of movies with LGBT themes or characters are exposed, on average, to one depiction of tobacco use for every 15 min of movie run-time. As a major component of the entertainment media environment, movies may contribute to smoking among LGBT people.