BACKGROUND-AIM:
While some contemporary portrayals of smoking may be driven by artistic or narrative choices, the persistence of tobacco imagery raises concerns about ongoing indirect industry influence and the normalization of tobacco use. This review examines the influence of the tobacco industry on film content through funding or other incentives that encourage the inclusion of tobacco-related scenes and imagery. Such content may shape audience behaviors and potentially promote harmful or unhealthy practices, particularly among young people. The aim is to develop recommendations that limit tobacco-industry influence and strengthen public health protection.

METHODS:
A scientific literature search was conducted using the Consensus Search Engine, drawing on sources such as Semantic Scholar and PubMed. Additional online searches were performed on relevant institutional websites, including the Truth Initiative, the Centers for Disease Control and Prevention (CDC), and NORC at the University of Chicago. The research question focused on the extent and nature of tobacco-industry influence on film portrayals of tobacco imagery and scenes in recent years.

RESULTS:
Tobacco imagery in films remains widespread globally, including in recent productions, where it often glamorizes smoking and rarely depicts its negative health consequences. One report from the U.S. Centers for Disease Control and Prevention (CDC) found that one in four youth-rated movies continues to include tobacco imagery, and that the decline in the number of movies featuring smoking stalled between 2010 and 2018. A recent report by NORC revealed that tobacco or nicotine imagery was present in 51% (77 of 152) of top films released in 2024, up from 41% (58 of 141) in 2023. The number of tobacco-related incidents increased by 43%, reaching 2854 incidents, compared with 1.989 in the previous year. This growing exposure to tobacco in films is a significant public health concern, given the well-established causal relationship between exposure to smoking in movies and youth initiation of tobacco use.

CONCLUSIONS:
Stronger policies are needed to curb tobacco imagery in films, reduce youth exposure, and protect public health. Recommended measures include: regulating tobacco-industry involvement in film production to limit the inclusion of imagery that may encourage harmful behaviors; introducing mandatory health warnings before films containing tobacco-related scenes, clarifying that such content is included solely for narrative purposes and is not intended to promote imitation; requiring studios to certify that they have not received payments or incentives from tobacco companies; and encouraging governments to discontinue subsidies for films that depict tobacco use.