Humphrey Bogart and Lauren Bacall in “The Big Sleep.” (Photo Copyright 1945 Turner Entertainment Co. All Rights Reserved)

It’s not exactly news that anti-smoking advocates would like to see images of tobacco banished from the movies. And this February, the issue reemerged in the form of a lawsuit against the Motion Picture Association of America, the National Association of Theatre Owners, Disney, Paramount, Sony Pictures Entertainment, Twentieth Century Fox, Universal and Warner Brothers, essentially blaming the movie business for youth smoking in America. The MPAA and the other organizations named in the suit have argued that it ought to be tossed on the grounds that it’s an attempt to quash their free speech.

But whatever the outcome of the case, the debate about smoking and the movies raises important questions about the history of government regulation of the movies, the ability of an industry to regulate itself, and the best ways to advocate for changes to what we see on our movie screens.

At the crux of the anti-smoking advocates’ lawsuit is the demand for “an injunction to stop defendants from continuing to rate films with tobacco imagery as ‘G,’ ‘PG,’ or ‘PG-13,'” though it makes a very narrow exception for situations where “the presentation of tobacco clearly and unambiguously reflects the dangers and consequences of tobacco use or is necessary to represent the smoking of a real historical figure who actually used tobacco.” (So much for period pieces with fictional characters!)

But how is the MPAA actually doing on that score? The Classification and Rating Administration, which assigns those ratings, began considering depictions of smoking by any characters, not just children or teenagers, in assigning letter grades in 2007. And in the years since, the administration has kept statistics on how many of the movies it has rated have depicted tobacco smoking, and what ratings they ended up receiving.

Between May 2007 and May 2015, CARA has rated approximately 6,700. Fifty-four percent of those movies depicted either smoking or tobacco imagery. That can mean that either that a main character in a film is smoking, that someone passing in the background of a scene is taking a puff, or that a pack of cigarettes or an ash tray is visible in a scene, implying that someone either has or is about to light up. Of those 3,600-odd movies, 72 percent of them were rated R or NC-17, many of them vaulting over that hurdle for reasons that had nothing to do with smoking. Twenty-one percent were rated PG-13. Six percent were rated PG, and just two movies — one released in 2007 and another that came out in 2008 — both depicted smoking and earned G ratings.

“As one who sees more movies probably than anyone in the country day after day, I notice that there is much less smoking on screen, and certainly in contemporary film. You always get films of, say, World War II, that will include smoking, but the reality is we gave cigarettes away in the ration packs to the GIs,” Joan Graves, who chairs the administration, told me when I asked her impression of how smoking on film has changed over the years. “Before, in films you’d always see a band of teens smoking or people in a bar smoking. And let’s face it, the laws in our country have changed; in many places, smoking in bars isn’t allowed anymore.”

Outside studies confirm Graves’s impression that on-screen smoking is in decline. It’s worth reading through the sections on media in the 2012 surgeon general’s report “Preventing Tobacco Use Among Youth and Young Adults.” The depiction of specific tobacco brands in the top box-office hits fell between 1996 and 2007, and the percentage of the top 100 movies that depicted smoking fell from 91 percent in 1996 to 63 percent in 2005. One study “showed a steady and considerable decline in tobacco content of movies since 1950, with total tobacco-related content peaking around 1961,” as well as a fall in smoking by main characters over the same period. There are years when those statistics tick back upward; movie-making is a creative industry, and different movies are going to depict smoking differently.

These downward trends don’t erase Hollywood’s troubling history with tobacco. They don’t make up for the fact that tobacco companies worked with movie studios to broker endorsement deals that paid major stars to shill cigarettes. And it doesn’t change the fact that, as Richard Kluger put it in his tobacco-industry history, “Ashes to Ashes,” “During the war years, the cultural habituation of Americans to their cigarettes was seductively advanced by Hollywood . . . actors had discovered the protean uses of smoking on celluloid to enhance their craft. To convey callow anxiety, you lit up fumblingly, whereas the powerful, controlling screen personality did so with a masterful flick.”

I can understand why anti-smoking advocates want to make smoking in the movies as marginal as possible; the potential financial hit that comes with an R rating is a powerful disincentive to include anything that might trigger it. But the idea of an R rating as an effective way to prevent children and young adults from seeing positive depictions of smoking relies on one rather shaky assumption: that teenagers don’t watch R-rated movies.

In fact, as the 2012 surgeon general’s report acknowledged, “Although policies to reduce smoking in youth-rated movies might limit adolescents’ exposure to movie smoking, about 40% of the exposure to this risk factor comes through adolescents watching movies rated for adults. Thus, an additional approach to limiting risk would be to encourage parents to control the exposure of their children
to adult-rated movies.”

But there are options to address smoking and media influence that don’t rely on letter grades and parental panopticons. In the same surgeon general’s report that outlines the impact movies and television have on young viewers and their choices around tobacco, I counted references to at least four studies that suggest that showing graphic anti-smoking warnings or airing anti-smoking advertisements before movies made teenagers less likely to find the smoking they saw on-screen attractive or compelling.

Aggressive anti-smoking advertising is a solution that wouldn’t mandate that artists approach their work under any particular constraints, and that wouldn’t force CARA to act without the attention to context that guides the board’s decision-making. And it certainly wouldn’t open the door — as mandatory policies around ratings very well could — to a rush of lawsuits suggesting that depictions of anything from guns to unprotected sex ought to trigger required ratings.

If that sounds like hysteria, it’s worth looking back at the rich history of government involvement in movie ratings and censorship. The 1915 Supreme Court ruling in Mutual Film Corp. v. Industrial Commission of Ohio denied the movies the same free speech protections that books and theatrical productions received. And as William J. Mann details in his book “Tinseltown,” states and localities responded by censoring movies for offenses ranging from starring Fatty Arbuckle to showing “a woman making baby clothes, on the ground that children believe that babies are brought by the stork.”

Absent very real free speech concerns, I suppose we could choose to return to a system where who gets to see what at the movies is determined by public-health officials and culture wars about public morals. But if there are other options available to us that might help us achieve similar health outcomes, I’m not sure why we would.