ABSTRACT
Objective. To understand the current status of smoking cessation for children, age less than 20 years old.
Methods. We investigated the clinical characteristics of patients, less than 20 years old, to Tokuyama Clinic, Urasoe, Okinawa, Japan during September 2010 to August 2013. Initial questionnaires and medical records were reviewed. We aimed to complete a 3-month outpatient treatment, supported by medical therapy (depending on the degree of nicotine dependence) and behavioral therapy.
Results.
Clinical Characteristics: A total number of 62 patients (N = 62; male 46, female 16) was studied. The mean age at first visit was 15.1 years. The mean age at start of smoking was 12.6 years old, mean age at habitual smoking onset was 13.1 years old. The mean number of cigarettes smoked was 9.8/day. The relationship to other smokers living with the subject were distributed as none (N=23, 37.1%); father (N=20, 32.3%); mother (N=12, 19.4%); both parents (N=3, 4.8%); and other family members (N=4, 6.5%). The major reasons for visits were “their own will to quit smoking” (N=39, 62.9%) and “sent here by my school” (N=37, 59.7%). The major motivations for visits were “high cost of cigarettes,” “concerns to own health,” and “to improve physical strength.” Feelings toward cigarettes included “I want to quit smoking” and “I regret smoking.” Subjects acquired cigarettes “from senior students or friends who lent their taspo cards [adult identification cards] to buy cigarettes” or “from adults who bought cigarettes for them in shops” or “from their parents buying cigarettes for them.”
Treatment outcomes: Two patients (3%) had already quit smoking at the time of first visit and continued not to smoke for 3 months and later. Five patients (8% ) continued coming to the hospital for 3 months and successfully quit smoking. Thirty-six patients (58%) stopped coming before the end of the 3 months: among them, nine had successfully quit smoking and 27 patients had not quit smoking by the last visit. Nineteen patients (31%) did not return for the next visit after the first session.
Discussion. Even though about 60% of the patients had hoped to quit smoking through their free will, only at around 10% were able to do so successfully. Considering the fact that half of the patients did not continue coming to the hospital, it is apparent that other supports are necessary.
Conclusions. As social environments have a great impact on starting and habitual smoking, general support from cooperation such as the school, community, home, and medical system is essential for smoking cessation, in particular among children.

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