Violent video games like this season’s "Grand Theft Auto: Vice City" have rekindled a debate over the role violent video games play in the lives of children.

The debate centers on whether or not children who are exposed to today’s increasingly realistic and graphic video games are more likely to exhibit violent behavior in real life.

"Violent video games are a risk factor for violent behavior, the same way smoking is a risk factor for cancer," said Dr. Douglas Gentile, director of research for the National Institute on Media and the Family. Gentile cited an Institute study that showed children who play violent video games are two to ten times more likely to get into a physical fight than children who don’t play violent games.

"Because they’re still called games, many people assume they must still be OK for kids," Gentile said, "The industry has really changed. These games are made by adults, for adults, and I don’t think many parents realize that the hottest games this holiday season put the players in the role of a sociopath."

Ashley Vanarsdall, a spokeswoman for the Interactive Digital Software Association, was quick to point out that over 70 percent of video games are rated E, for Everyone, by the Entertainment Software Ratings Board (ESRB). Video games that are rated M, for Mature audiences 17 and older, make up a much smaller portion of the video game market.

"In 2002 to date only 7 percent of all games involve players shooting enemies from a first person perspective," Vanarsdall said. Vanarsdall also cited studies by the U.S. Surgeon General and the Washington State Department of Health that downplay the negative effects of playing violent video games.

"Violent crime, particularly among the young, has decreased dramatically during the 1990s while video games have steadily increased in popularity," Vanarsdall said, "suggesting that, if anything, one could make a stronger argument that increased video game sales correlate to reduced youth violence, not the other way around."

But Daphne White, executive director of the Lion and Lamb Project, thinks that young children who can’t always distinguish between fantasy and reality should not have access to violent games.

"Why do you think kids believe in Santa Claus? They live in a fantasy world," White said. "We’re cramming their minds with games that say violence doesn’t make people get hurt."

White also said that the video game industry isn’t being responsible enough in its marketing of violent games to children.

"They can’t spend millions of dollars marketing to kids and then say, ‘Just say no,’" White said. "It’s like the tobacco industry placing all the blame on smokers. You get them hooked and then say, ‘They should have just stopped.’ They’re making ever more extreme content while doing nothing to restrict the marketing."

Gentile agreed. "The industry needs to make sure it’s not hyping these [violent] games to the extent that it’s getting lots of kids excited," he said. "If the game really is for adults, market it only to adults as much as you can."

Matt Kagan, a spokesman for the ESRB, said that his organization’s Advertising Review Council is making sure the industry does just that. "There are marketing rules that are in effect that prohibit ads for M rated games in TV shows or magazines that have substantial youth audiences," Kagan said. If a company breaks these rules, the ESRB has the authority to enforce a variety of corrective actions, including hefty fines.

Kagan stressed that these breaches of advertising rules do not happen very often. "It has happened but it is rare," Kagan said. "It’s certainly not an everyday occurrence."

But Gentile said the way games are marketed is only part of the problem, and safeguards need to be adopted at the retail level to stop children from having access to violent video games.

"If your two-year-old walks in with fifty dollars, they could walk out with an M-rated game," Gentile said of stores like Best Buy that do not restrict the game’s children purchase. "Their current policy is: If you have the money, you can get it. The retail industry should have policies in place so that they’re not selling games to kids beyond their rating."

Kagan said that while the ESRB strongly encourages stores to enforce rating standards in their sales policies, they do not have the authority to force individual stores to stop selling M-rated games to children.

"Every store is different and has different policies," Kagan said. "We wouldn’t tell a store exactly how to enforce our ratings. We encourage them to uphold the system."

Kagan added that most video game retailers do a good job of keeping M-rated games out of the hands of children. "Most retailers have really stepped up and are doing quite a lot," Kagan said, pointing to chains like Wal-Mart, Blockbuster and Kay-Bee Toys as examples of stores with measures in place to prevent children from buying M-rated games.

Andrea Frasier, assistant manager of local FuncoLand video game store, said that she is not allowed to sell M-rated games to children without a parent present, by order of the chain’s corporate office. Frasier said that every day she has to turn away five to seven children that want to buy the M-rated "Grand Theft Auto: Vice City" but aren’t old enough. Even when parents are there to buy a violent game for their child, Frasier said she makes sure to warn them about the content. "I tell them to check the ratings poster we have by the counter, and try to tell them a little bit about the game," Frasier said. "Most of them just don’t care."

But Teresa Dudley, a 39-year-old mother of two young children, said she definitely does care about what her children play. "These violent games are so desensitizing to kids," said Dudley, a teacher and part time sales associate at Toys R Us. "I wouldn’t let my kids get an M-rated game. Their absolutely not getting ‘Vice City.’"

"It’s up to the parents to exercise control over what their children are watching," Dudley added. "I play the games with my kids. You can’t just sit them in front of a screen and leave them."