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This year’s slogan adopted by the World Health Organization for No Tobacco Day (May 31) is “Tobacco: deadly in any form or disguise.” Since the framework convention on tobacco control came into effect in February 2005, the antismoking movement has become an irreversible global trend.

In Japan, some progress has been made in the antismoking drive following the implementation of the health promotion law — which includes a provision to prevent smoking in public places — and, increasingly, the adoption of local ordinances prohibiting smoking on the street. In addition, medical insurance coverage for tobacco addiction treatment started last month.

Prevention-oriented public health policy, such as measures aimed at discouraging the smoking habit, is becoming more important as a way of easing financial strains on the public medical insurance system, already aggravated by the aging of the population, the declining birthrate and ever-growing medical expenses.

The health promotion law has had some effects in expanding restrictions on smoking, although it has no teeth against violators. It is up to the good will of those concerned to observe the law. The health ministry seems unenthusiastic about implementing the full extent of the law.

Antismoking nongovernmental organizations say that newly appointed tobacco-control officers at the health ministry, as well as the tobacco policy information director at the National Institute of Public Health, are not fulfilling their functions.

Last month, a smoking ban was finally introduced at the headquarters of the health ministry. For a government office in charge of public health policy, the ban was overdue, coming 20 years after the U.S. Department of Health and Human Services adopted a similar measure.

The health ministry’s Web site “Tobacco or Health” is merely perfunctory. It still makes mention of a $368.5 billion U.S. federal out-of-court settlement proposed in 1997 over suits filed by state authorities against tobacco manufacturers over states’ demands for reimbursement of the medical costs accrued to treat tobacco-related health problems. (The proposal was nullified when the Senate rejected related bills.) Strangely, though, the Web page offers no information on the $206 billion legal settlement reached in 1998 over the same suits.

The Web site carries no information on Japanese court rulings on smoking, some of which are important. For example, the Tokyo District Court in July 2004 ordered authorities of Tokyo’s Edogawa Ward to pay a 50,000 yen solatium to Masahiro Kawamura, 36, a ward office employee subjected to the passive effects of tobacco smoke.

As of the end of 2005, the framework convention on tobacco control had been signed by 168 nations and ratified by 116 nations. Not only industrial countries but also Asian countries and regions, including Thailand, Singapore, Hong Kong, South Korea, Taiwan and Bhutan, have implemented tougher smoking restriction measures than Japan.

Laggard Japan is not qualified to seek permanent membership on the U.N. Security Council until the government does more to strengthen the nation’s efforts to restrict smoking.

First, restrictions should be tightened on smoking by minors, who are more susceptible than adults to nicotine addiction. Enforcement of the law banning underage smoking should be strengthened. More than half a million minors annually receive police warnings for smoking, but only a dozen or so vendors are fined for selling tobacco to minors.

The Finance Ministry is supposed to revoke the licenses of tobacco vendors fined for violating the law, but ministry officials can’t recall any such revocations in recent memory. They say this is because police have difficulty proving violations, but clearly police and the ministry are lax in cracking down.

U.S. authorities reportedly use sting operations to nab vendors selling cigarettes to minors. They recruit a teenager to buy cigarettes from a vendor, and a plainclothes officer keeps watch to catch the vendor red-handed. Violators not only are fined but also have their operating license revoked or suspended. I believe Japan should try a similar operation.

Second, smoking in taxis should be banned altogether. At present, there are practically no restrictions on smoking in a cab, although the health ministry issued a directive that taxis be included among public transport systems subject to smoking restrictions under the health promotion law. Only about 2 percent of all taxis in Japan can be considered nonsmoking. Last December and again this month, Japanese courts dismissed damage suits over the harmful, passive effects of smoke filed by cab drivers and passengers against the government and taxi companies. In both cases, the courts ruled that existing law made it impossible to award damages but noted that a total ban on smoking in taxis was desirable.

Inhalation of smoke in the confined space of a cab can seriously damage health. Since taxi operators are unwilling to introduce a voluntary ban on smoking, the transport ministry should implement the measure through legislative action or administrative guidance.

Third, the outdated tobacco business law, aimed at “the healthy development of the tobacco industry,” should either be abolished, or revised to incorporate clauses for measures to promote public health. Under present law, cigarette prices and warnings on health damage printed on cigarette packages are controlled by the Finance Ministry, which tends to take a position favorable to the tobacco industry as the majority shareholder of Japan Tobacco Inc.

As a result, cigarette prices in Japan are much lower than in the West, and packages carry only weak warnings about health damage. Space given over to warnings is minimized and there is no illustration of health damage.

Japan lags behind other countries in tobacco control mainly because the Finance Ministry, which plays a leading role in the compilation of the budget, has a strong say. Under the leadership of the health ministry, Japan should establish a comprehensive tobacco control law, which would include warnings on cigarette packages about the health effects of smoking, information on cigarette pricing, restrictions on the installation of cigarette vending machines, and compulsory measures to prevent passive smoking.

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