ABSTRACT Backgrounds: Smoking in childhood has become an important public health concern. Previous studies have reported on secular trends in childhood smoking rates and compared with smoking rates at fixed ages. They also described secular trends regarding the prevalence of smoking at fixed ages. The variations in smoking rate of young children and adolescents by follow-up groups have not been studied by follow-up groups at a national level. Objective: We looked at trends and generational impacts on smoking rate by using follow-up groups of male Japanese high school students to quantitatively assess differences in trends, based on multiple nationwide data from the Japanese Youth Tobacco and Drinking Surveys gathered every 4 years between 1996 and 2008. Methods: The surveys were nationwide, cross-sectional random sampling surveys given every 4 years from 1996 to 2008, using the single-stage cluster sampling methodology. The cluster unit of the sampling was school. The survey targeted junior and senior high school students from schools selected through Japan using the National School Directory. Students enrolled in the sampled schools were subjects of the study. Participants were 53,925 high school students from 7th grade to 11th grade in 1996, 2000, 2004 and 2008. We divided the three follow-up groups every 4 years
from 1996 to 2004 for male junior high school students in 7th grades, age 13. The end periods were 4 years later when they had become 11th graders, age 17, from 2000 to 2008. Main outcome measures in this study were life time smoking, current smoking within 30 days and daily smoking at 7th or 11th grade and the trend of the smoking rates between 7th to 11th grades. Results: Life time smoking rate, current smoking rate and daily smoking rate in Japanese high school students decreased at 7th grade from 1996 to 2004. They also decreased at 11th grade from 2000 to 2008. However, the slopes differed among their follow-up groups. The increments in their smoking rates from 7th grade to 11th grade in male high school students were smaller in recent follow-up groups both in 2000 and in 2004 than in follow-up groups in 1996. Then, those increments in follow-up groups between in 2000 and in 2004 were similar in lifetime smoking rate and current smoking rate. Conclusions: We have shown that monitoring trends by follow-up group are important in studying smoking for public health. Values of smoking rates from a young age to adolescence by follow-up group should be examined. Values of smoking rate and regular changes in smoking rate are important because smoking rate changes dynamically during adolescence. Not only trends in smoking rates at fixed ages, but also generational impacts should be considered by using follow-up groups to study smoking behaviors among students. We need to continue careful monitoring of follow-up group smoking prevalence. When long-term health promotions are planned or assessed, policy makers need to look at changes in follow-up groups.
Cite this paper
Kanda, H. , Osaki, Y. , Kaneita, Y. , Itani, O. , Ikeda, M. and Ohida, T. (2013) Smoking rate trends of male 7th and 11th graders in Japan based on repeated, nationwide, cross-sectional surveys every 4 years from 1996 to 2008. Health, 5, 1241-1246. doi: 10.4236/health.2013.58168.
 Warren, C.W., Jones, N.R., M.P. Eriksen and Asma, S. (2006) Global Tobacco Surveillance System (GTSS) collaborative group: Patterns of global tobacco use in young people and implications for future chronic disease burden in adults. Lancet, 367, 749-753.
 Osaki, Y., Minowa, M.. Suzuki, K. and Wada, K. (2003) Adolescent smoking behavior in Japan, 1996. Japanese Journal of Alcohol and Drug Dependence, 38, 483-491.
 Global Youth Tabacco Survey Collaborative Group (2002) Tobacco use among youth: A cross country comparison. Tobacco Control, 11, 252-270.
 Warren, C.W., Jones, N.R., Peruga, A., Chauvin, J., Baptiste, J.P., Costa de Silva, V., el Awa, F., Tsouros, A., Rahman, K., Fishburn, B., Bettcher, D.W., Asma, S. and Centers for Disease Control and Prevention (CDC) (2008) Global youth tobacco surveillance, 2000-2007. MMWR Publications, Surveillance Summary, 57, 1-28.
 Chen P.L., Huang, W., Chuang, Y.L., Warren, C.W., Jones, N.R. and Asma, S. (2008) Prevalence of tobacco use among junior high and senior high school students in Taiwan. Journal of School Health, 78, 649-654.
 US Department of Health and Human Services (1994) Preventing tobacco use among young people: A report of the surgeon general. US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Health Promotion, Office on Smoking and Health, Atlanta.
 Szklo, M. and Niet, F.J. (2000) Epidemiology: Beyond the basics. Aspen Publishers, Frederick.
 Twisk, J.W.R. (2003) Applied longitudinal data analysis for epidemiology: A practical guide. Cambridge University Press, Cambridge.
 Fitzmaurice, G.M., Laird, N.M. and Ware, J.H. (2004) Applied longitudinal analysis. John Wiley & Sons, Hoboken.
 Cochran, W.G. (1977) Single-stage cluster sampling: Clusters of unequal sizes. In: Sampling Techniques, 3rd Edition, Wiley, New York, 249-273.
 Osaki, Y., Minowa, M., Suzuki, K. and Wada, K. (2004) Nationwide survey on adolescent smoking behavior in Japan, year 2000. Kosei no Shihyo, 51, 24-32.
 Osaki, Y., Tanihata, T., Ohida, T., Minowa, M., Wada, K., Suzuki, K., Kaetsu, A., Okamoto, M. and Kishimoto, T. (2006) Adolescent smoking behaviour and cigarette brand preference in Japan. Tobacco Control, 15, 172-180.
 Osaki, Y., Tanihata, T., Ohida, T., Kanda, H., Kaneita, Y., Minowa, M., Suzuki, K., Wada, K. and Hayashi, K. (2008) Decrease in the prevalence of smoking among Japanese adolescents and its possible causes: Periodic nationwide cross-sectional surveys. Environmental Health and Preventive Medicine, 13, 219-226.
 Bricker, J.B., Peterson Jr., A.V., Leroux, B.G., Andersen, M.R., Rajan, K.B. and Sarason, I.G. (2006) Prospective prediction of children’s smoking transitions: Role of parents’ and older siblings’ smoking. Addiction, 101, 128-136. doi:10.1111/j.1360-0443.2005.01297.x
 Soteriades, E.S. and Di Franza, J.R. (2003) Parent’s socioeconomic status, adolescents’ disposable income, and adolescents’ smoking status in Massachusetts. American Journal of Public Health, 93, 1155-1160.
 Farkas, A.J., Gilpin, E.A., White, M.M. and Pierce, J.P. (2000) Association between household and workplace smoking restrictions and adolescent smoking. JAMA, 284, 717-722. doi:10.1001/jama.284.6.717
 Alexander, C., Piazza, M., Mekos, D. and Valente, T. (2001) Peers, schools, and adolescent cigarette smoking. Journal of Adolescent Health, 29, 22-30.
 Powell, L.M., Tauras, J.A. and Ross, H. (2005) The importance of peer effects, cigarette prices and tobacco control policies for youth smoking behavior. Journal of Health Economics, 24, 950-968.
 Kanda, H., Osaki, Y., Ohida, T., Kaneita, Y. and Munezawa, T. (2011) Age verification cards fail to fully prevent minors from accessing tobacco products. Tobacco Control, 20, 163-165. doi:10.1136/tc.2010.036947
 Moore, L., Roberts, C. and Tudor-Smith, C. (2001) School smoking policies and smoking prevalence among adolescents: Multilevel analysis of cross-sectional data from Wales. Tobacco Control, 10, 117-123.
 Wold, B., Currie, C., Roberts, C. and Aaroe, L.E. (2004) National legislation on school smoking restrictions in eight European countries. Health Promotion International, 19, 482-488. doi:10.1093/heapro/dah410
 Office on Smoking, Health, and Division of Adolescent and School Health (2004) Cigarette use among high school students, United States, 1991-2003. MMWR, 53, 499-502.
 National Centre for Social Research (2006) Drug use, smoking and drinking among young people in England in 2005. NHS Health and Social Care Information Centre, Public Health Statistics, National Health Service, London.
 White, V. and Hayman, J. (2003) Smoking behaviours of Australian secondary students in 2002. National drug strategy monograph series No. 54. Department of Australian Government, Canberra.
 Health Canada (2005) The national strategy: Moving forward? The 2005 progress report on tobacco control. The obacco Control Liaison Committee, Ottawa.
 Hibell, B., Anderson, B., Bjarnason, T., et al. (2004) The ESPAD (European School Survey Project on Alcohol and Other Drugs) report. The Swedish Council for Information of Alcohol and Other Drugs, Stochholm.
 Hublet, A., De Bacquer, D., Valimaa, R., Godeau, E., Schmid, H., Rahav, G. and Maes, L. (2006) Smoking trends among adolescents from 1990 to 2002 in ten European countries and Canada. BMC Public Health, 6, 280.
 Taylor, A.L. and Bettcher, D.W. (2000) WHO framework convention on tobacco control: A global “good” for public health. Bulletin of the World Health Organization, 78, 920-929.
 Kiriike, N., Nagata, T., Sirata, K. and Yamamoto, N. (1999) Are young women in Japan at high risk for eating disorders? Decreased BMI in young females from 1960 to 1995. Psychiatry and Clinical Neurosciences, 52, 279-281.
 Tanner, J.M., Whitehouse, R.H. and Takaishi, M. (1966) Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965 part I. Archives of Disease in Childhood, 41, 454-471.