title: Tobacco control challenges in East Asia: proposals for change in the world's largest epidemic region.
abstract: East Asia is one of the world's largest tobacco epidemic regions. Although several international studies have evaluated the status of tobacco control in this region, the findings have not been integrated with knowledge on domestic activities at the national and municipal levels. We analysed the current tobacco control situation in three East Asian countries, Japan, China and the Republic of Korea, using both international and domestic data sources. We collected data between 2008 and 2011 in each country according to the framework of WHO's MPOWER (Monitoring, Protect, Offer, Warn, Enforcement and Raise) approach for guiding implementation of the WHO Framework Convention on Tobacco Control. Analysis revealed that 37-53% of adult men were current smokers and that smoking prevalence among middle-aged men reached 63%. Less than 20% of male smokers plan to quit and the use of nicotine replacement drugs was 14% at maximum. Forty-six percent or more of men and 20% or more of women were exposed to passive smoking at workplaces and at home, respectively. Many tobacco industry activities remain unrestricted and prevalent. Our findings indicate an urgent need for the following set of policies: raise cigarette prices to increase the quit attempt rate, particularly among adult men; develop a multi-component quitting assistance system to provide adequate assistance for smoking cessation; implement effective smoke-free policies in workplaces and public places to reduce exposure to passive smoking; and rebuild the administrative structure to denormalise tobacco industry activities. The importance of these standard approaches should be reaffirmed by all tobacco control policymakers in East Asia.
authors.affiliation: Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Katanoda
authors.affiliation: Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea.
authors.forename: Sohee
authors.initials: S
authors.lastname: Park
authors.affiliation: National Cancer Information Center, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Lim
authors.affiliation: Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Qiao
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Manami
authors.initials: M
authors.lastname: Inoue
mesh_terms: D001210:Asia, Southeastern; D005260:Female; D006284:Health Plan Implementation / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006293:Health Promotion / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006801:Humans; D008297:Male; D012907:Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence*; D016540:Smoking Cessation / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D019460:Tobacco Industry / Q000331:legislation & jurisprudence; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000517:prevention & control*
keywords: Global health; Public policy; Surveillance and monitoring