The World Health Organization is urging Hollywood to do more to keep tobacco off the silver screen. It’s made smoking in the movies the focus of Saturday’s World No Tobacco Day.

“The WHO is calling on the entertainment industry, in particular the world of films and fashion, to stop promoting a product that kills every second regular user,” the global health organization said.

World No Tobacco Day is celebrated every year on May 31 as a way to draw attention to the dangers of tobacco use. Global activities this year include fashion shows, art exhibits, seminars, and petitions urging an end to tobacco use in film and fashion.

Young people are especially vulnerable to the glamorous images of smoking portrayed in many movies, advocates said.

"The fact is, even though it’s a fantasy, there’s very strong empirical evidence that it affects behavior,” said Stanton Glantz, PhD, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, and founder of Smoke Free Movies.

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Several studies conducted by researchers at Dartmouth Medical School have found that kids who watch a lot of movies that show smoking are more likely to start smoking themselves, and have more positive attitudes about smoking.

And smoking in movies – especially the PG-13 movies targeted at impressionable adolescents – is on the rise.

A recent report by the Massachusetts Public Interest Research Group found that tobacco use in film has increased by 50% since 1998, the year tobacco companies reached a major legal settlement with 46 US states. That agreement prohibited tobacco firms from advertising to minors, and from paying film companies to use their products in movies.

“The biggest problem with (smoking in movies),” said Tom Glynn, director of cancer science and trends for the American Cancer Society, “is that it begins to appear as a normal behavior, when in fact it’s a behavior that only 1 in 5 adults participate in. But the impression one would get is that it’s something most adults do, and that’s a problem.”

The WHO and other advocates are calling on the film industry to take four concrete steps against tobacco.

They want movie producers to run a statement in each movie’s end credits certifying that no one in the production received any money from tobacco companies or their agents. The idea is based on the current animal welfare statements many movies contain, assuring viewers that no animals were harmed during production.

Advocates also want strong anti-tobacco ads to run before any movie that contains images of tobacco. And in movies that do show tobacco use, they want the brand to be indistinguishable.

But perhaps most controversially, the WHO is urging film executives to give any movie that shows tobacco use an R-rating.

“It substantially reduces the probability a kid will see the movie,” Glantz said.

Smoking is currently not one of the criteria the Motion Picture Association of America uses to determine the rating each film should get. But Glantz says the organization should take tobacco just as seriously as it takes profanity. Coarse language can be enough to get a film rated R. Violence, nudity or drug abuse in a movie can also earn it an R.

But Glantz is quick to note that he’s not advocating censorship of movies.

“I’m not saying they can’t put anything bad in, but if they do, it should be properly labeled,” he said.

The WHO is also looking to the fashion industry to change practices it says help promote tobacco. In particular, the organization is calling for an end to tobacco-sponsored fashion shows and awards, and an end to pictures of smoking models.

These types of events help advertise a product that kills some 5 million people worldwide, the WHO says.

“The world of film and fashion cannot be accused of causing cancer,” the organization said. “But they do not have to promote a product that does.”