Policy and politics of smoking control in Japan
Introduction
The health hazards of smoking tobacco have been known for decades, yet many countries have faced difficulties in controlling smoking American Cancer Society, 1990, Kluger, 1996. Although the Japanese government has taken some steps in an attempt to control cigarette smoking, Japan has had, and continues to have, one of the highest prevalence among the industrialized countries. Furthermore, lung cancer has become the most prevalent cancer among males in the nation. In order to understand the present situation in Japan it is necessary to examine the policy and the politics regarding smoking control. Government policy on health issues, in general, is rarely a product of technocratic processes and instead is mostly a product of politics. This paper documents the historical evolution of smoking control and its consequences since the 1950s. It then reviews past findings on smoking control policy and politics in other countries, proceeds to a discussion of the reasons why the present set of smoking control policies in Japan is ineffective and why this ineffectiveness exists. Finally, it seeks to elucidate the critical factor in the promotion of smoking control in Japan and other countries.
Section snippets
History of tobacco in Japan
Tobacco was first brought to Japan by the Portuguese early in the 16th century. Besides the importation of tobacco leaves, the seeds of the plant were put into the ground almost simultaneously. At first, tobacco planting in rice fields was strictly prohibited by local governors. In spite of this, by the early 17th century the cultivation of tobacco had spread throughout the country as far as the northern part of mainland Japan. In 1615 and 1616, the Shogun started issuing proclamations that
1950–1975: subgovernment politics before the nonsmokers' right (NSR) movements
Since the mid-1950s, medical findings on the hazardous effects of smoking have been on the increase in the US and in Europe, and the issue of smoking and health increasingly has attracted public notice ever since. Early in this period there were some especially significant alarms sounded: the 1954 statement by UK Health Minister Macland that smoking and lung cancer were statistically associated; the 1957 American Cancer Association report stating that smokers die at younger ages; and the 1957
Knowledge and opinion
Available data shows that public knowledge about smoking hazards increased over several decades, although no consecutive, well-designed survey has been conducted to monitor this. The following is a summary of fragmentary findings from past studies: In 1970, 53% of those responding to surveys said they knew that smoking causes lung cancer (PMO, 1973, p. 351). In 1978, about 65% of people knew that smoking is associated with lung cancer, while more than 85% did so in 1987. The knowledge about its
Discussion
Prevalence is the most useful indicator for assessing a smoking control program (Lopez et al., 1994). In the past, several countries have experienced a substantial decline in smoking prevalence. In the US, overall smoking prevalence declined from 40.4% in 1965 to 29.1% in 1987. The rate of decline between 1965 and 1985 was 0.84 percentage points per year Fiore, 1989, Pierce, 1989. Between 1974 and 1987, the average rates of change in smoking prevalence were −0.91 among males and −0.33 among
Conclusion
The tobacco industry took root well before the hazards of its products were proven scientifically. As elsewhere, smoking control policy did not proceed automatically and smoothly in Japan. Examination of the past political process discloses that the failure to enact effective smoking control is attributable to several factors, including political environment, administrative inadequacy and an inactive medical community. Especially remarkable has been the political leverage of the tobacco
Acknowledgements
The author appreciates the early review of and comments on this paper by Professor Michael Reich, Professor John Montgomery and Professor Allan Brandt of Harvard University. Generous support provided by Professor Shunichi Araki of the University of Tokyo is also acknowledged.
References (155)
Smoking and weight control in teenagers
Public Health
(1984)- et al.
The potential for using excise taxes to reduce smoking
Journal of Health Economics
(1982) Australia: implications of court award for workplace smoking
The Lancet
(1992)Decentralisation trends in the management of New Zealand's Health Services
Health Policy
(1989)Tobacco taxation in Australia
Economic Papers
(1992)World smoking and health
American Cancer Society
(1990)- American Medical Association, 1987. Model legislation on the enforcement of laws to restrict children's access to...
History of the War Against Smoking: 1964–1978
(1978)Science, advocacy and health policy
Journal of Public Health Policy
(1991)- et al.
Public policy and smoking prevention: implications for research
Anthropological overview of substance abuse
The Alabama Journal of Medical Sciences
Perceived believability of warning label information presented in cigarette advertising
Journal of Advertising
Cigarettes: prevention or cure?
Harvard Medical School Health Letter
The Norwegian Tobacco Act
Health Education Journal
Fifteen years of comprehensive legislation: results and conclusions
Environmental change as a method of smoking control: the case of workplace smoking bans
Licit and Illicit Drugs
Restriction on smoking: growth in population support between 1983 and 1991 in Ontario, Canada
Journal of Public Health Policy
Cigarette Sales to Minors – Colorado, 1989
Journal of American Medical Association
Cigarette smoking among youth – United States, 1989
Mortality and Morbidity Weekly Report
Evaluating Tobacco Control Activities: Experiences and Guiding Principles
The opium wars revisited as US forces tobacco exports in Asia
American Journal of Public Health
Cigarette Product Liability Litigation
Crackdown on smoking
Maclean's
Political approaches to smoking control: a comparative analysis
Applied Economics
An evaluation of the effectiveness of tobacco-control legislative policies in European Community countries
Scand. J. Soc. Med.
Current trends in cigarette advertising and marketing
New England Journal of Medicine
Tobacco liability litigation as a cancer control strategy
Journal of the National Cancer Institute
Worldwide Litigation
Legislative efforts to protect children from tobacco
Journal of American Medical Association
RJR Nabisco's cartoon camel promotes camel cigarettes to children
Journal of American Medical Association
The coalition on smoking or health: an example of the benefits of coalition building to influence national policy
The effects of combining education and enforcement to reduce tobacco sales to minors
Journal of American Medical Association
Trends in cigarette smoking in the United States
Journal of American Medical Association
Mass media and smoking cessation: a critical review
American Journal of Public Health
Public Policy and the Smoking Health Controversy
Smoking and Politics: Policy Making and the Federal Bureaucracy
Achieving a smoke-free society
Circulation
Tobacco: the road to litigation
Addiction
Tobacco liability and public health policy
Journal of American Medical Association
Cited by (23)
Challenges and opportunities for greater tobacco control in Japan
2019, International Journal of Drug PolicyCommunity-level socioeconomic status and parental smoking in Japan
2012, Social Science and MedicineCitation Excerpt :If all people lived in communities with highest prevalence of employment in tertiary industries, the total risk of smoking in the population would drop 0.071. Especially in Japan, public-health policies on smoking are relatively unadvanced (Sato, 1999). However, there have been some changes; the Health Promotion Law was enacted in 2002, and smoking prevalence is certainly falling.
Learning from Philip Morris: Japan Tobacco's strategies regarding evidence of tobacco health harms as revealed in internal documents from the American tobacco industry
2004, LancetCitation Excerpt :The WHO's 6th World Conference on Smoking and Health in Tokyo also took place in November of that year. Anticipating an increase of anti-smoking sentiments from these events, Japan Tobacco established the Smoking Research Foundation under the Ministry of Finance (in 1986) and, in February of 1987, the five major tobacco companies doing business in Japan—Japan Tobacco, Philip Morris, RJ Reynolds, Brown and Williamson, and Rothmans Marubeni—established the Tobacco Institute of Japan to champion the cause of cigarettes and (especially) to refute the growing evidence of health hazards.15–17 Japan's collaboration with international tobacco companies was weak before the mid-1980s.
Public place restrictions on smoking in Canada: Assessing the role of the state, media, science and public health advocacy
2004, Social Science and Medicine