Recognizing its potential, the American Academy of Pediatrics, 18 the Centers for Disease Control and Prevention, 22 and the US Office of National Drug Control Policy 23 have called for the use of media literacy to reduce harmful health behaviors such as smoking. 19, 20 Media literacy has been shown to be both feasible and teachable, 20, 21 making it attractive as an intervention. 18 Acknowledging the effects of mass media on attitudes and behavior, media literacy teaches youth to understand, analyze, and evaluate advertising and other mass media messages, enabling them to actively process media messages rather than passively remain message targets.

Media literacy therefore represents a promising framework for development of innovative school-based tobacco control programs. 11 – 13 Exposure to mass media messages such as promotions and advertisements also significantly increases the risk of smoking initiation by adolescents. For instance, more than half of adolescent smoking initiation has been linked to watching smoking in movies. 8 – 10 Research has demonstrated a strong association between exposure to certain mass media messages and smoking in adolescents. Youth aged 8 to 18 years are exposed to 8 hours 33 minutes of mass media content daily, 7 including a substantial number of positive portrayals of cigarette smoking.

2 However, traditional school-based smoking prevention programs have not been successful in affecting clinically relevant smoking behaviors. Cigarette smoking is the leading cause of preventable death and disease in the United States, 1 and about 90% of those who die from smoking began during adolescence.

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