Special communication Tob Control: first published as 10.1136/tobaccocontrol-2012-050852 on 17 April 2013. Downloaded from control challenges in East Asia: proposals for change in the world’s largest epidemic region Kota Katanoda,1 Yuan Jiang,2 Sohee Park,3 Min Kyung Lim,4 You-Lin Qiao,5 Manami Inoue6

▸ Additional material is ABSTRACT Despite the large health burden of tobacco use in published online only. To view East Asia is one of the world’s largest tobacco epidemic East Asia, comprehensive and comparative informa- please visit the journal online (http://dx.doi.org/10.1136/ regions. Although several international studies have tion on the present status of tobacco control in this tobaccocontrol-2012-050852). evaluated the status of tobacco control in this region, region is scarce. Although several international 1 the findings have not been integrated with knowledge studies have provided valuable data related to Surveillance Division, Center 7–11 for Cancer Control and on domestic activities at the national and municipal tobacco control in individual countries, no Information Services, National levels. We analysed the current tobacco control situation study has integrated the data with domestic activ- Cancer Center, Tokyo, Japan in three East Asian countries, Japan, and the ities at the national and municipal levels to build 2 fi Tobacco Control Of ce, Republic of Korea, using both international and domestic region-specific strategies. The present study aimed Chinese Center for Disease Control and Prevention, data sources. We collected data between 2008 to analyse the current status of tobacco control in , China and 2011 in each country according to the framework of three countries in East Asia ( Japan, China and the 3Department of Epidemiology WHO’s MPOWER (Monitoring, Protect, Offer, Warn, Republic of Korea) to develop policy strategies for and Health Promotion, Enforcement and Raise) approach for guiding changing the world’s largest tobacco epidemic Graduate School of Public implementation of the WHO Framework Convention on region. Health, Yonsei University, – Seoul, Korea Tobacco Control. Analysis revealed that 37 53% of 4National Cancer Information adult men were current smokers and that smoking METHODS Center, National Cancer prevalence among middle-aged men reached 63%. Less We d e fined East Asia as a geographical area includ- Control Institute, National than 20% of male smokers plan to quit and the use of ing Japan, mainland China, Taiwan, the Republic Cancer Center, Goyang, Korea ’ 5Cancer Institute/Hospital, nicotine replacement drugs was 14% at maximum. of Korea, and the Democratic People s Republic of Chinese Academy of Medical Forty-six percent or more of men and 20% or more of Korea. The present study analysed data from three Sciences, Peking Union women were exposed to passive smoking at workplaces countries ( Japan, mainland China and the Republic copyright. Medical College, Beijing, China 6 and at home, respectively. Many of Korea). We have discussed the status in Taiwan Epidemiology and Prevention activities remain unrestricted and prevalent. Our findings based on the available literature. In the following Division, Research Center for fi Cancer Prevention and indicate an urgent need for the following set of policies: sections (including tables and gures), we refer to Screening, National Cancer raise prices to increase the quit attempt rate, mainland China as China and the Republic of Center, Tokyo, Japan particularly among adult men; develop a multi- Korea as South Korea, for simplicity. component quitting assistance system to provide We set six themes (Monitoring, Protect, Correspondence to http://tobaccocontrol.bmj.com/ Dr Kota Katanoda, Surveillance adequate assistance for smoking cessation; implement Offer, Warn, Enf