Matao Yamamoto, a 67-year-old former Kyoto cab driver, is one of a large number of smokers in Japan who deeply regrets acquiring the hard-to-quit habit.
Yamamoto, a patient of pulmonary emphysema and a member of a group of smokers suing Japan Tobacco Inc. and the state, said smokers are also victims of the tobacco industry.
“I started smoking when I was about 13, out of adoration for what appeared to be an adult habit,” he said. “Then I simply got addicted and could not quit until I found out it was actually killing me.”
After smoking more than 60 cigarettes a day for more than 30 years, Yamamoto was hit with the serious disease in 1996. He now needs to carry an oxygen canister everywhere he goes and a five-step stairway has become a formidable obstacle for him.
“More than half a century after I started smoking, teenagers today are still seduced into smoking for the same reasons,” he said. “I just feel so angry with JT and others in the tobacco industry who continue selling such hazardous products to minors by taking advantage of their ignorance and by hiding its addictive nature and ill effects.”
The civil suit was filed by Yamamoto and six other plaintiffs suffering from lung or throat cancer or pulmonary emphysema in 1998 at the Tokyo District Court against the world’s third-largest tobacco company as well as the government for approving the sales. The plaintiffs are demanding 10 million yen each in damages. Two of them have since died of what are claimed to be tobacco-related diseases.
The plaintiffs are also demanding that more exact and detailed health warnings be printed on cigarette packs, which currently only read “Since it may harm your health, let’s be careful not to smoke too much.”
They are also demanding a ban on tobacco advertising and cigarette machines, which currently number about 620,000 nationwide and are believed contributing to the increasing number of minors who smoke.
But despite the plaintiffs’ hopes for an immediate settlement, mainly due to their severe illnesses, the litigation has dragged on and threatens to stall over a fundamental issue — whether smoking is hazardous or not.
Expert testimony on risks
Toshihide Tsuda, an epidemiologist at the state-run Okayama University’s medical school, said he was surprised after being asked by the plaintiffs’ lawyers to testify on the damage caused by smoking at a hearing earlier this year.
“That tobacco poses higher health risks, of lung cancer for instance, was common knowledge in Western countries in both academic circles and mainstream society by the mid-1960s,” he said. “To testify to the ill effects of smoking is hardly a tall order, even for a graduate student (in epidemiology).”
Tsuda said that the gridlock in the suit symbolizes the failure of society to openly acknowledge the health risks of smoking, even to this day.
“If the court recognizes the health risks of smoking, it would be sensational news in Japan,” he said. “But if the court denies it, it would be an even bigger sensation in the rest of the world.”
Due partly to people’s ignorance of the health risks, Japan has the fourth-highest smoking rate in the world. According to a survey conducted by JT, 53.5 percent of adult men and 13.7 percent of women were smokers as of May.
In and outside court, JT has consistently claimed that the health risks allegedly associated with smoking have not been scientifically proven and that psychological dependence is only minimal.
Such claims, however, sound empty now, considering that the Health, Labor and Welfare Ministry acknowledged that smoking increases health risks considerably and that tobacco is highly addictive.
In its white paper in 1997, the ministry stated that cigarettes contain more than 4,000 chemical substances, including more than 40 carcinogens, and that smoking increases the risk of death from lung cancer by a factor of 4.5 and significantly increases the risk of other forms of cancer.
The white paper also says smoking increases the risk of heart attack 1.7 times, and the possibility of pulmonary emphysema, bronchitis and other diseases.
It also mentions the serious health risks to pregnant women and fetuses as well as that of secondhand smoking, especially to children.
Referring to a report by the World Health Organization, the ministry estimates that around 100,000 Japanese annually die prematurely from tobacco-related diseases.
A survey conducted by the ministry in 1998 said about 64.2 percent of smokers wanted to either quit smoking or reduce the number of cigarettes they smoke.
Japan Tobacco stands firm
Akira Ogawa, vice head of Japan Tobacco’s corporate communications, reckoned tobacco represents a “possible health risk factor,” but said the causal relationship between smoking and a particular disease has not been fully proven etiologically.
He said the company believes nicotine has only a modest “psychological dependence” but not physical addiction, and it is easy to quit smoking.
“If nicotine is so addictive, why can people still quit?” Ogawa asked, citing the country’s population of smokers, which has decreased by some 1 percent annually for the past five years.
If it is not a nicotine addiction, what has supported high smoking rates in Japan is the country’s “culture,” which has allowed tobacco to survive as a predominant male habit for four centuries, he argued.
“Tobacco has served as a handy item for easy relaxation among Japanese people for centuries,” he said. “Why can’t we call tobacco itself a part of our culture?”
Responding to the mounting scientific evidence of the risks of smoking, the health ministry has conducted programs to urge minors to stay away from smoking, to promote smoking-free environments and to assist smokers in quitting smoking since 1995.
As part of a 10-year health strategy, Health Japan 21, which was put forward in March, seeks to raise public awareness of the health risks associated with smoking.
“From the perspective of public health, making the nation’s smoking population smaller is a priority, but the public still remains ignorant of many of the risks,” said Nobuyuki Takakura, director of the ministry’s lifestyle-related disease control division.
“We cannot overlook the cost of smoking to the state, in the form of premature deaths and of additional medical expenses.”
A research body affiliated with the ministry has estimated that tobacco-related health care annually costs about 1.2 trillion yen.
It remains unclear how long JT can hold onto its current claim that tobacco may not be hazardous, considering that its products for export carry warnings such as “Smoking seriously damages your health,” or more directly, “Tobacco causes lung cancer” or “heart disease.”
Domestic sales of Marlboro brand cigarettes by JT, under a license agreement with the U.S. tobacco giant Phillip Morris Products Inc., also leave JT open to charges of double standards.
While Phillip Morris acknowledged in 1999 that tobacco poses serious health risks and is addictive, JT sells the same product while maintaining that tobacco’s ill effects are not scientifically proven.
Surviving in a new world
Japan Tobacco is now paying between 200 million yen and 300 million yen annually to 46 U.S. states, depending on its market share in each state.
The money, in addition to $1.4 million the firm paid to the states last year, is linked to a 1997 court-mediated settlement between four U.S. tobacco giants and the 46 states, which require the U.S. firms to pay a total of $206 billion to state governments by 2025 to cover medical expenses for American citizens with tobacco-related diseases.
Although JT was not one of the defendants, the firm decided to make the payment “as a necessary expenditure to conduct business in the United States,” officials of the company said.
In Europe, JT is also under pressure. The European Parliament has approved new legislation aimed at banning the use of descriptive terms such as Light and Mild for cigarette products after September next year. Under the regulation, JT will not be allowed to sell its popular Mild Seven cigarettes.
Even under internationally tightening tobacco regulations, JT is believed to be hoping to expand its tobacco business, making the firm an exception among tobacco firms in developed countries.
Amid the barrage of lawsuits in the U.S. accusing tobacco companies of selling hazardous products, American tobacco firms have been struggling hard to reduce their reliance on tobacco business, and have diversified their businesses partly through M&As.
Around 800 suits involving the tobacco industry, including one in which Phillip Morris was ordered by a California court in June to pay $3 billion to a lifetime Marlboro smoker, are currently under way in the U.S.
In stark contrast, JT purchased the international division of the U.S. tobacco giant RJR Nabisco Holding Corp., which sells Camel, Winston and Salem cigarettes, for $7.79 billion in 1999 to expand business overseas, especially in developing countries.
While the firm’s officials claim that the company has made efforts to diversify its business since its privatization in 1985, its food and pharmaceutical sectors brought no profit to the company as of the end of fiscal 2000.
In the third quarter of that business year, about 94.8 percent of the company’s profits came from domestic tobacco sales and 12.1 percent came from business abroad. A part of the revenues offset its 14.4 billion yen in losses from other business.
On the other hand, Phillip Morris cut its dependence on tobacco business to 65.1 percent by the end of last year.
Experts express their concern over JT’s purchase of RJR, arguing that it may force the firm to shoulder massive amounts of damages, which may in turn become a financial burden on the Japanese taxpayer as the tobacco firm is still semigovernmental. Two-thirds of the firm’s stocks are legally mandated to be owned by the Finance Ministry.
“Tobacco companies are being sued everywhere and have already been ordered to pay extremely huge sums of money in the United States,” said Tsuda of Okayama University. “It is not only shameless to buy a new tobacco business abroad but also a very stupid decision.”
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