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Asian Pac J Cancer Prev. 2008 Apr-Jun;9(2):239-45.

Factors related to starting and continuing smoking among senior high school boys in Fukuoka, Japan.

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Department of Preventive Medicine, Division of Social Medicine, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.


The purpose of this study was to identify factors that influence starting and quitting smoking among Japanese male adolescents aged 15-18. Two thousand and twelve senior high school boys in Fukuoka City, Japan, answered unsigned self-administrated anonymous questionnaires in July 2001. Odds ratios (ORs) and their 95 % confidence intervals (CIs) were computed to assess the strength of associations between students' smoking status and alcohol consumption habits. Additionally, the link between a students' smoking status and parental influence (parental smoking) was also assessed. Approximately 90% of the students, both current and ex-smokers, had ever smoked prior to senior high school while 77% of the students (smokers and non-smokers) had the experience of drinking alcohol prior to admission to senior high school. After adjustment for school year (i.e., freshman, sophomore, junior, senior), academic education level, after-school club activities, time of first drinking experience and the frequency of drinking, there was a significant increased risk to become a smoker when one parent was a smoker (OR = 1.67, 95% CI = 1.18-2.37) or when both parents were smokers (OR = 2.94, 95% CI = 1.66-5.18) compared to both parents being non-smokers. The consumption of alcohol prior to entering senior high school was significantly associated with more than 2.5-fold greater risk for the onset of smoking when compared to the risk of becoming a smoker when alcohol consumption started after entering senior high school. An increased frequency of drinking was also associated with starting smoking (OR =14.00, 95% CI = 8.08-24.26; 2-3 times/week vs. never). Similarly, an increase in drinking frequency resulted in less likelihood of smoking cessation. For instance, the data showed that, the subjects were 1/3 less likely to quit smoking. Paternal smoking had a significant impact on whether or not a child would quit smoking (OR = 0.55, 95% CI = 0.38-0.81) as compared to a child that had paternal and maternal non-smokers. This study suggested that drinking habits started earlier than smoking habits among adolescents. Many students had already experienced drinking before admission to senior high school, while the experience of smoking mostly typically started after admission to high school. These data show the urgency of developing anti-smoking educational programs that could be developed and introduced prior to admission to high school.

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