Indian cinema-goers are exposed to 14 billion images of tobacco use in Bollywood films each year, says a study, calling for measures to deal with this exposure. The study, undertaken by Delhi-based NGO HRIDAY in collaboration with Imperial College London, involved content analysis of 44 top grossing Bollywood films screened between 2006 and 2008. The study also found that half of the youth think Bollywood films contain tobacco imagery.  Strong evidence exists to support the fact that depiction of tobacco use in films leads to tobacco use, especially among children and adolescents, estimated the study "Tobacco imagery in Bollywood films: 2006-2008" published in the Heart Asia Journal.

It said many teenagers light their first cigarette or use their first tobacco product after watching tobacco use onscreen. "The popularity of Bollywood films and their outreach to a large Indian population, including children and adolescents, does highlight the need to regulate this exposure, to protect the young and vulnerable minds from being influenced by tobacco use shown onscreen," said Monika Arora, one of the co-authors of the study. "Fourteen billion impressions each year is a startling number and this study points towards the need for a dialogue and policy response to address this concern," she added.

The World Health Organization recommends that films with tobacco content should be given an adult rating. Indian government issued a notification in September 2012 which requires films to include warnings about the dangers of tobacco use but provides no guidance on ratings. According to Gaurang Nazar, lead author on the study: "Restriction of youth access to films depicting tobacco imagery by reconsidering the Indian film rating system would complement other tobacco control measures in India." The Global Youth Tobacco Survey (India) conducted in 2009 reveals that nearly 15 percent of youth currently use tobacco in India.