Introduction

Tobacco remains the largest cause of preventable death, killing 8.7 million people per year and resulting in widespread morbidity and illness (World Health Organization 2021a, b, c). Whilst there are many factors involved in smoking prevalence, there is now causal evidence that exposure to smoking content in the media is associated with experimentation and subsequent use (U.S. Department of Health and Human Services 2012, Leonardi-Bee et al. 2016, Hassenein et al. 2022).

Whilst tobacco use rates are decreasing globally, attention has been called to the slow rate of decline among women, which is declining at a much slower rate than men, and is increasing in some countries (World Health Organization 2021a, b, c), leading to an increased public health priority to reduce smoking in this demographic. Advertisement, promotion and sponsorship using the media is a common tactic for promoting smoking to this demographic, often coopting women’s empowerment movements, and portraying characters as glamorous, fashionable, cool and of high social status which may translate, to positive smoking messages (World Health Organization 2021a, b, c).

The television programme ‘Sex and the City’ regularly featured smoking and this was often used as a plot device linked with the themes of sexuality and female empowerment (Borio 2004, Arthurs 2010), with some suggesting that linking smoking to the female image uses a tactic historically employed by the tobacco industry (Straussner and Brown 2002) to market smoking amongst this demographic.

‘And Just Like That’ is the follow up to ‘Sex and the City’ following the characters as they navigate life in their 50s (Internet Movie Database 2022b). With the presence of smoking imagery in ‘And Just Like That’ being reported as a positive feature, indicating that ‘the reboot won’t be a total drag’ (New York Post 2021), the current study aimed to explore how much tobacco imagery was shown throughout Series 1.

Method

Season 1 of ‘And Just Like That’ included 10 episodes which aired between 9 December 2021 to 3 February 2022 via HBO Max in the US, Or Now TV & Sky in the UK. We explored all 10 episodes using a semi-quantitative one-minute interval coding which has been widely used before (Barker et al. 2018a, b, 2019a, 2022) to explore tobacco content. The method includes recording the presence or absence of audio-visual tobacco content in every one-minute interval across four categories; actual use (actual smoking shown on screen), implied use (any inferred use without actual use being shown on screen), paraphernalia (the presence of tobacco or other related materials) and branding (the presence of clear and unambiguous branding). Tobacco content was coded as present if it appeared during any one-minute coding period. Multiple instances of appearance in the same category during the same one-minute period were considered a single event, and appearances that transitioned into more than one interval as separate events. Data coding was completed in Microsoft Excel and, on completion, data were entered into IBM SPSS Statistics 28 for statistical analysis.

To ensure the reliability of coding, a sample of 2 of the 10 episodes (20%) were coded independently by two coders (JB and AB).

Results

The 10 episodes included 394 one-minute intervals of content, with individual episodes ranging from 35–44 minutes. Tobacco content occurred in 45 intervals (11% of the total) across all 10 episodes (Table 1).

Table 1 Number of intervals and episodes containing tobacco content
Full size table

Actual tobacco use was seen in 21 intervals with actual cigarettes being seen the most in 4 intervals. Implied tobacco use was seen in 23 intervals and paraphernalia were seen 11 intervals. The only brand identified was Dunhill which was verbally referenced in one interval in one episode.

Discussion

This study demonstrates that, despite the 18 year age gap between the end of the ‘Sex and the City’ TV series and the start of ‘And Just Like That’ (Internet Movie Database 2022b), and the declining smoking rates during that time (Action on Smoking and Health 2022), tobacco content is still regularly featured in these programmes, as they are in other forms of contemporary media such as films, broadcast TV and video-on-demand content. Whilst viewing figures are not available for this series, we know that this was HBO Max’s most streamed show of all time and was highly popular (Screenrant 2021). It is, therefore, likely a lot of people were exposed to tobacco content through this programme. Ratings for the programme, however, are provided via IMDB and can be broken down into age groups as a proxy; whilst most reviews are in the 30–44 (30%) and the 45+ age ranges (15%), a noteworthy percentage are from the 18–30 age group (7%) (Internet Movie Database 2022a)( 1 = figures correct as of 02/11/2022). Previous research has noted that the final series of ‘Sex and the City’ glamourised smoking by linking it to sex (Borio 2004). Whilst the final series was released 18 years prior to ‘And Just Like That’, it is likely that the key demographic for this programme, middle aged women who viewed the original programme, are likely to be influenced by ongoing depictions as encouragement to keep smoking, similarly to how Carrie took up smoking again in the final series by noting ‘everybody smokes’ (Borio 2004). The characters from ‘Sex and the City’ and now, ‘And Just Like That’, are symbols of female empowerment (Adriaens and Van Bauwel 2014), and the tobacco content in these programmes links its use with positive smoking portrayals. It is likely that the tobacco content found in these programmes will have an effect on female viewers, both young and those who have returned to ‘And Just Like That’ 18 years after the original programme.

‘And Just Like That’ was released via paid services or video-on-demand services which allow users to watch whatever they choose at any time of day. Video-on-demand services broadcast programmes to multiple countries around the world, and have been previously shown to show more tobacco content than traditional broadcast TV (Barker et al. 2019b), likely leading to widespread cross border exposure to tobacco content (Royal College of Physicians 2021, World Health Organization 2022) and thus expanding the likely impact of the reported imagery.

The current study presents a detailed investigation of the entire first series of ‘And Just Like That’, and whilst this likely led to widespread exposure to this content based on the popularity of the programme, we cannot say with certainty as viewing figures are unavailable. Future studies should aim to include this. We also cannot know the demographics of the audience viewing this content, however, the themes of female empowerment are likely to affect female viewers. Future studies should explore the subjective effect of smoking portrayals in ‘And Just Like That’ and whether this acts as tobacco promotion.

As there is a causal link between exposure to tobacco content in the media and uptake (U.S. Department of Health and Human Services 2012), programmes such as ‘And Just Like That’ present a public health challenge. With season 2 of ‘And Just Like That’ confirmed to air in 2023 (Cosmopolitan 2022), there should be monitoring of whether this trend continues. And just like that, it appears tobacco content is common in popular TV programmes again.