Implementation and Evaluation of Smoking Prevention Program in a Japanese Elementary School Setting: Results from a Three-year Follow-up

Despite the scientific facts of the detrimental effects of tobacco and the anti-tobacco law for teenagers, smoking among minors is still a public health concern in Japan. This study was conducted to (1) identify the prevalence, attitudes, knowledge, and environmental factors of smoking among adolescents, and (2) evaluate the smoking prevention program offered at an elementary school. The subjects were 244 junior high school students; 96 subjects had undergone a smoking prevention program three years prior to this (experimental group), and 148 subject had not (comparison group). A self-administered questionnaire was completed by the subjects and their parents. Of the subjects, 45.9% were boys, and no gender difference was found between the two groups. The overall prevalence of smoking experience was 16.0%: boys, 15.2%; girls, 16.8% (N.S.); experimental group, 12.5%; comparison group, 18.4% (N.S.). A majority of subjects indicated knowledge about the harmful effects of smoking including second-hand smoking, and there were no significant differences between the experimental and comparison groups. Significantly, more subjects in the experimental group had knowledge about the increased risks of diabetes and periodontal diseases by smoking than those in the comparison group. In addition, it was found that the prevalence of smoking experience tended to be higher in subjects with current smokers in their family than those without (p=0.07). Although the program had some significant effects on gaining knowledge about harmful smoking, it did not result in lowering the prevalence of smoking experience. Implementing a program including parents might be effective for this population.