One year since the World Health Organization’s Framework Convention on Tobacco Control went into effect, Japan’s smoking rate still remains high compared with other developed nations. The government needs to create a strong momentum toward lowering the rate.
In 1990, the smoking rate among Japanese adult males topped 60 percent. It was down to 53.5 percent in 2000, went below 50 percent for the first time in 2001 and fell to 45.8 percent in 2005, according to Japan Tobacco Inc. The rate for Japanese adult females has hovered at about 14 percent for the past four decades; the 2005 figure stood at 13.8 percent.
Compared with the peak of 83.7 percent for Japanese males in 1966, the decline appears laudable.
Other developed countries have performed better. The smoking rate is at 20 to 30 percent for both males and females in the United States and Britain, and at 30 to 40 percent in Germany and France, according to WHO.
In Japan, the top smoking group comprises men in their 30s, 54.6 percent of whom smoke. Among Japanese women, those in their 20s and 30s are on top — 20.9 percent for both age groups.
WHO says that tobacco is the second leading cause of death globally, accounting for nearly 5 million deaths a year. It further says that unless steps are taken to control tobacco use, the annual death toll from smoking will reach 10 million by 2020.
The WHO tobacco treaty bans or greatly limits tobacco advertising, requires warnings labels to take up at least 30 percent of the space on cigarette packages and prohibits or restricts misleading language such as “mild,” “light” and “low tar.” It also commits nations to develop measures for curbing tobacco use and protecting nonsmokers.
In Japan, various such measures have been taken at different levels. In May 2003, the health promotion law went into effect, aimed at preventing exposure to passive smoke in public places. Some local governments have introduced bylaws that prohibit smoking on the street. Many enterprises, hospitals and public organizations have either banned smoking or designated separate areas for smokers.
In 2004, officials from several government ministries and agencies set up a liaison committee to discuss measures to rein in smoking. Last year, posts were set up for officials specifically to deal with tobacco-related problems at the Health, Welfare and Labor Ministry and the National Institute of Public Health. Following recommendations of the Central Social Insurance Medical Council, a program to help smokers quit will be covered by health insurance beginning April 1. If the number of cigarettes a person consumes per day times the number of years that he or she has smoked 200 or more, the person can enroll in the 12-week-long program. The patient will pay 30 percent of the total cost, or 2,880 yen.
For the “Healthy Japan 21” project, which started in 2000, the health ministry has set numerical targets to be achieved by 2010 for decreasing liquor consumption, salt intake and obesity, and for increasing physical exercise, the intake of varied nutrients, etc. But the ministry did not set a numerical target to lower the smoking rate and per capita tobacco consumption because of strong resistance from the tobacco industry.
Within the ministry’s expert committee, voices argue that the incidence of tobacco-related diseases will not drop unless the smoking rate does. The government needs to set numerical targets for the smoking rate and a year to achieve it. That would be useful in pushing measures to control tobacco use and examining the effects of such measures. More than anything else, targets would serve as a strong signal to people that the government is earnest in its campaign to curb smoking and thus save lives.
A survey of about 2,000 smokers nationwide aged 20 to 69 by the Tokyo-based Smoking-Cessation Information Center shows that 51.2 percent of them say they would stop smoking if the price of a pack of cigarettes rose to 500 yen and that 73.4 percent would quit if one pack cost 1,000 yen. Beginning July 1, the price of one cigarette will go up by 1 yen. Even so, the price of a pack of cigarettes in Japan is about a half or less of what it is in North America and Europe, where a pack ranges from about 500 yen to 1,000 yen. The government has tended to regard tobacco sales as an easy source of tax revenue.
The cost of tobacco use in terms of national medical expenditures should be taken into account when deciding on tobacco prices. Restrictions on tobacco vending machines, which are practically ubiquitous, are also needed to deter youngsters from acquiring the habit. To fight smoking, the government should work out a clear strategy and take concrete and visible measures on as many fronts as possible.
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