1. Tobacco Control and Children Asian and US Collaboration Fumio Bessho Department of Pediatrics Kyorin University School of Medicine

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

3. Tobacco Control To protect children from second-hand tobacco exposure To prevent for children to start smoking

4. 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.

5. Age at starting to smoke (years old) (per 100,000) Standardized mortality rate for male (1966-1982) (ganjoho.jp)

6. Youth is a Target of Sales Promotion of Tobacco Industries

7. * 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.) ① Campaign for prevention of minor’s smoking ② Warning on news paper ③ Self-controlling of advertise- ment and sales promotion ④ Vending machine equipped with apparatus recognizing minor * ① ② ③ ④ JT’s CSR Report 2010

8. 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).”

9. JT sponsors children’s Shogi contest. JT supports NPO’s Activities to promote Children’s sound development. Afforestation by JT With billboard stating “JT’s Forest”

10. 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)

11. 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)

12. Non- Smokers Early Smokers Strum und Drang Addicted Smokers Regular Smokers 70% 7% Heavier Smokers 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

13. 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