Shifting Patterns of Smoking in Young Women and the Media: Tobacco Use in the Television Series Sex and the City

Theoretical Background and research questions/hypothesis: The role of the media in displaying, normalizing, and promoting tobacco use via television and movies has been carefully documented. Meanwhile, opportunities for leveraging the reach and influence of the media for tobacco control are underutilized. A case study of cigarette smoking in the television series Sex and the City was conducted. The series was set in New York City (NYC), a major media center, and targeted to young women.  

Methods: Smoking content over time in each season (n = 6) and episode (n = 94) of the series along with tobacco control measures that potentially influenced young women in NYC during this same general time period (1998-2005) were examined. Population estimates of smoking prevalence for women aged 18-34 years in NYC and the United States overall from 1998-2005 were obtained from the Behavioral Risk Factor Surveillance System (BRFSS).

Results:Three-quarters (76%) of all Sex and the City episodes contained at least one instance of cigarette smoking, but this percentage decreased over time from 100% in 1998-1999 to 30% in 2003-2004. Likewise, mean cigarette count per episode and cigarette incidents per hour on the series showed a general decrease over time, with a low level in 2002, the year that intensive tobacco control measures were instituted in NYC. BRFSS estimates of smoking prevalence for NYC women aged 18-34 years paralleled the average cigarette counts per season on Sex and the City. 

Conclusions:One plausible interpretation might be that the events on the series, and thus the tobacco content counts, mirrored actual smoking prevalence patterns in young women in NYC when it originally aired (1998-2004), albeit at a much higher level on the series. Hard hitting ads in NYC have since served to decrease the smoking prevalence of young women in NYC yet further.

Implications for research and/or practice:By recognizing the potential of the media in urban centers such as NYC to shift population distributions of smoking in targeted groups, media may be more effectively harnessed as an environmental tool for tobacco control.