Accordingly, on September 26, 1990, the MPAA
replaced X with NC-17, intending that the rating be
applied not to pornography, but only to films that
many parents would not want their children to see.
The first film so labeled wasHenr y and June(1990), a
sexually explicit account of the affair between writ-
ers Henry Miller and Anaïs Nin. Other notable films
of the 1990’s rated NC-17 includedShowgirls(1995),
Crash(1996), andTwo Girls and a Guy(1997)—all for
explicit sexual content.
Impact During its first two years, the NC-17 rating
was given to 41 pictures, or roughly 3.5 percent of all
films that were rated by the MPAA in 1990 and 1991.
However, these numbers quickly declined. From
1992 through 1999, only 35 pictures were rated NC-
17, representing less than one percent of the 5,292
films that were rated during these eight years. Be-
cause the NC-17 rating is usually applied to sexual,
rather than violent, content, it carries much the same
pornographic stigma as the former X. By eliminating
a large part of a film’s potential audience (those sev-
enteen and under), the NC-17 rating is rarely wel-
comed by filmmakers, theater owners, and viewers.
Further Reading
Sandler, Kevin S. “The Naked Truth:Showgirlsand
the Fate of the X/NC-17 Rating.”Cinema Journal
40, no. 3 (Spring, 2001): 69-93.
Vaughn, Stephen.Freedom and Entertainment: Rating
the Movies in an Age of New Media. New York: Cam-
bridge University Press, 2006.
James I. Deutsch
See also Basic Instinct; Censorship; Film in the
United States;Showgirls; TV Parental Guidelines
system.
Nicotine patch
Definition A transdermal patch intended to help
smokers quit
Date Introduced in the United States in 1992
Introduction of the nicotine patch, also known as trans-
dermal nicotine replacement therapy, offered hope to mil-
lions of smokers who wanted to break a life-threatening ad-
diction.
For most of the twentieth century, smoking was ac-
ceptable, and even glamorous, but in 1964, the U.S.
surgeon general reported that smoking was danger-
ous to health. By the 1970’s, the deaths of millions of
Americans were attributed to smoking-related ill-
nesses—lung cancer and other respiratory and car-
diovascular diseases. In 1988, Surgeon General C.
Everett Koop called smoking “the chief, single,
avoidable cause of death” in America, highlighting
its highly addictive nature. Cigarette companies de-
nied the dangers of smoking, but secret documents,
leaked to the public in 1994, revealed that they had
repeatedly lied to Congress and manipulated the
contents of cigarettes to increase addiction. In 1995,
the Food and Drug Administration (FDA) declared
that cigarettes were drug-delivery devices and pro-
posed restrictions on marketing and sales. Cigarette
advertising was banned from television, and smok-
ing was banned on airplanes and in most public
places. By the end of the decade, taxes on cigarettes
had increased dramatically, and cigarette compa-
nies settled lawsuits with most states for smoking-
related illnesses.
Most people knew that smoking was harmful and
wanted to quit. When, in 1992, four drug companies
introduced nicotine patches (available by prescrip-
tion only), the demand for the patch far exceeded
the supply. The palm-sized circular patch, attached to
the skin on the back or upper arm every twenty-four
hours, delivered a steady dose of nicotine to help sat-
isfy physical cravings and reduce withdrawal side ef-
fects. After a month, ex-smokers could wean them-
selves by using successively smaller patches. Studies
comparing the patch to a placebo patch showed that
it doubled the odds of quitting for at least six months,
whether used alone or in combination with other in-
terventions. However, only 26 percent of those wear-
ing the patch quit smoking, as opposed to 12 percent
using the placebo. Many smokers continued to
smoke while using the patch, leading to toxic, and oc-
casionally, dangerous health risks. The patch became
available over the counter in 1996.Impact Demand for the patch spurred pharma-
ceutical companies and therapists to increase public
awareness of the dangers of smoking and to develop
other aids to help smokers quit. Limited success un-
derscored the complexity of addiction to tobacco
and challenged researchers in the field. Although
not a cure-all, the patch still offered a one-in-four
chance of quitting—roughly the odds of dying from
a tobacco-related illness if one continues to smoke.610 Nicotine patch The Nineties in America