Background: This study aimed to determine between-country differences and changes over time in the portrayal of youth risk behaviors in films rated for youth in Argentina, Brazil, Mexico and the United States. Methods: Content and ratings were analyzed for films that were popular across all four countries from to Country-specific ratings were classified as either youth or adult, and Generalized Estimating Equations were used to determine between-country differences in the presence of tobacco, alcohol, drugs, sexual content, and violence in youth-rated films.

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To examine the association between movie smoking exposure MSE and adolescent smoking according to rating category. A total of US adolescents were enrolled in a longitudinal survey conducted at 8-month intervals; subjects were followed up at 8 months, subjects at 16 months, and subjects at 24 months. A survival model evaluated time to smoking onset. The equivalent effect of PGrated and R-rated MSE suggests it is the movie smoking that prompts adolescents to smoke, not other characteristics of R-rated movies or adolescents drawn to them. An R rating for movie smoking could substantially reduce adolescent smoking by eliminating smoking from PG movies. The US Surgeon General has determined that the relationship between movie smoking exposure MSE and youth smoking is causal; however, it is not known whether movie rating influences how adolescents respond. In a recently published experiment, 2 exposure to movie clips portraying smoking as relaxing was associated with a significantly stronger desire to smoke compared with exposure to clips without a motive for the smoking. Although experimental studies allow the researcher to control exposure and serve to tease out underlying cognitive mechanisms, it is difficult to study actual smoking behavior in an experimental setting, and therefore it is hard to judge what the behavioral implications of the findings would be.