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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