The health ministry is drawing up a plan to halve the smoking rate in Japan from 23.4 percent in 2009 to 10 percent. Unfortunately, the plan is tucked into a long-range health promotion plan from 2013 to 2022.
Considering that the percentage of smokers stood at 38.2 percent among men and 10.9 percent among women in 2009, according to the health ministry’s own statistics, one wonders what the slow, cautious approach is all about?
Quite simply, it is too little too late.
In 2007, 129,000 people died from smoking-related causes in Japan, according to a study published this year in the U.S. journal PLoS Medicine. That study, one of the most extensive of its kind, isolated preventable risk factors and traced them to mortality.
Tobacco smoking was the most common cause of death among 16 factors affecting life expectancy. The others were, in order, high blood pressure, 104,000 deaths; physical inactivity, 52,000 deaths; high blood glucose, 34,000 deaths; high salt intake, 34,000; and alcohol use, 31,000 deaths. In each category, the number of deaths exceeds that from the tsunami and earthquake last March.
The Japanese government did initiate a health promotion campaign in 2000, called Health Japan 21. Few people have even heard of it.
The current proposal seems to be more of the same, even while new studies have found that tobacco use is a modifiable behavior, dependent on price, availability and social context.
If the government were really serious about reducing the 129,000 preventable deaths per year, it would increase the price, make tobacco less available and regulate smoking in all public places. More than that, though, the government would work to enact a genuinely health-conscious set of programs that would also help to reduce all risk factors.
Smoking and other unhealthy lifestyle choices are obviously a matter of individual choice. However, since the overall cost of health care is an issue linking everyone in Japan, it is also a choice with social implications.
The treatment and care of smoking-related diseases is an issue that affects everyone. We all pay for it in some way. As Japan has one of the highest life expectancy rates of any country in the world, one wonders how much higher it would be if the government were to take the leading cause of preventable deaths seriously.