Objective:
Numerous studies have examined whether school smoking prevention education for minors can reduce smoking rates in later life, but no consensus has been established. Doctors in Kanazawa, Japan, voluntarily visited elementary schools to provide smoking prevention education for 12-year-old students. We attempted to assess whether this education is effective for lowering smoking rates in students when they reach 20 years of age.

Methods:
We defined a community area that has 14 elementary schools for this study. We provided education at some of the 14 schools once a year for 12-year-old students. After 8 years, we carried out a questionnaire survey on smoking for 20-year-old young adults. We compared smoking behaviors at the age of 20 between the educated and the control groups of the 3 year period from 2015.

Results:
The smoking rate was significantly lower in the educated group, indicating that smoking prevention education in elementary schools for 12-year-old students, provided by doctors, reduced smoking behavior, even at the age of 20.

Conclusions:
Smoking prevention education for 12-year-old students at elementary schools by volunteer physicians significantly reduced smoking rate at the age of 20. Funding statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. There are no conflicts of interest by any author.