Tobacco Control and ChildrenAsian and US Collaboration

Fumio BesshoDepartment of Pediatrics

Kyorin University　 School of Medicine

Fumio Bessho Has documented that he has no financial relationships to disclose.

Tobacco Control

• To protect children from second-hand tobacco exposure

• To prevent for children to start smoking

We should put target for anti-tobacco on youths

• Many adult smokers start their smoking before the age of 18 years old.

• The younger the starting age of smoking is, the higher the incidence of adverse effect in their life is.

• Youths are good targets of tobacco industries as well as women.

0

100

200

300

400

500

600

700

-19 20-24 25-29 30-34 35 non-smoker

Lung Cancer

Whole cancer

Age at starting to smoke (years old)

(per 100,000)

Sta

nd

ard

ized

mo

rtal

ity

rate

fo

r m

ale

(196

6-19

82)

(ganjoho.jp)

Youth is a Target of Sales Promotion of

Tobacco Industries

* Initiative in prevention of minor’s smoking

(This activity must be managed not only by tobacco industry but also by community as a whole including nurture at home in order to succeed.)

①Campaign for prevention of minor’s smoking

②Warning on news paper

③Self-controlling of advertise-ment and sales promotion

④Vending machine equipped with apparatus recognizing minor

*

①

②

③

④

JT’s CSR Report 2010

Poster of campaign for prevention of minors’ smoking by Japan Tobacco supported by the Ministry of Education, Culture, Sports, Science and Technology and other National Agencies

such as the Department of Police

I have decided by myself “I don’t smoke (until 20 years old).”

JT sponsors children’sShogi contest.

JT supports NPO’s Activities to promoteChildren’s sound development.

Afforestation by JTWith billboard stating“JT’s Forest”

Behavior of Adolescents and Factors Influencing It’s Change (1)

• The medical message to youth --- not to start smoking is often either not delivered or not heard.– We, pediatrician are middle class or wealthy, highly

educated, and have left childhood far behind. We are speaking to children and families who do not have the benefit of our medical knowledge, are most often less wealthy, and often of different ethnicity.

(Gidding SS: J Pediatr 158:527-528, 2011)

• Different sources of Information (about sex) were associated with different types of underlying beliefs about having sex.– Using cousins or friends as a source of information was

associated with beliefs that having sex in the next 12 months would result in positive outcomes for one’s self and one’s partner.

– Getting information from these references led to a higher perception that their peers were having sex---.

– Beliefs related mothers and religious leaders were behavioral and those to fathers were normative.

(Bleakley A, et al: Am J Health Behav 33:37-48, 2009)

• Then, what is doctor’s position?

Behavior of Adolescents and Factors Influencing It’s Change (2)

Non-Smokers

Smokers

EarlySmokers

Strum und Drang

Addicted Smokers

Smokers

Regular Smokers

70%

7%

HeavierSmokers

18-19 years old 20-21 22-35 years old years old

Wrong Recommendation: Smoke after 20 years old!

Wrong Thought:More of my peers smoke.

Mind of Adolescent

Youth is a Target of Sales Promotion of

Tobacco Industries.

Our target should be also Youth.

1. Education for youth not to start smoking And also treatment of tobacco addiction

2. Combat against various tobacco industry’s tactics