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Five years have passed since the Framework Convention on Tobacco Control went into effect (Feb. 27, 2005). The FCTC, the first treaty negotiated under the auspices of the World Health Organization, has 168 parties and covers 86 percent of the world population. Nevertheless, tobacco products remain the cause of serious health damage, including cancer and cardiac and pulmonary diseases, and hampers fetal growth.

On Feb. 25, the health ministry issued a notice to prefectural and municipal governments, calling on them to make public spaces nonsmoking areas in principle. Although the notice does not provide for punishment of violators, it is a step forward in protecting people from secondhand tobacco smoke.

The “WHO Report on the Global Tobacco Epidemic, 2009” calls tobacco use “the leading cause of preventable death,” adding that it is estimated to kill more than 5 million people each year worldwide. It warns that if current trends continue, by 2030 tobacco will kill more than 8 million people annually the world over, and could kill a billion or more people by the end of this century. In Japan, more than 130,000 people each year die of health damage related to tobacco use.

In 2004, the Diet unanimously approved the FCTC and Japan became the 19th country to ratify the treaty. But Japan is lagging behind in controlling advertisements for tobacco products, using visual images on packages to warn of possible health damage from using such products, raising the sales price of tobacco products and preventing the inhalation of secondhand smoke. Japan needs to rectify this situation as other countries are pushing more aggressive smoke-free policies.

Raising the tobacco tax and abolishing the tobacco business law — whose purpose has been to nurture the “healthy growth” of the tobacco industry — are important. A 2008 WHO survey shows that in terms of progress in smoke-free policies, Japan was second to worst out of five categories, while Canada and Britain were ranked in the best category.

FCTC guidelines call on the parties to the treaty to take legal steps by the end of February 2010 to totally ban smoking in indoor public places and indoor workplaces. The health ministry’s Feb. 25 notice apparently takes this into consideration.

The notice declares that it is scientifically clear that secondhand smoke causes health damage. It reminds local governments that the health promotion law, which went into effect in May 2003, calls on managers of places where people gather to take necessary measures to prevent secondhand smoke.

Because the law has not led to sufficient efforts to prevent secondhand smoke, especially in restaurants and workplaces, the notice says that in principle, smoking should be totally banned in spaces used by many people and that clear notices should be put up to win over the understanding and cooperation of people who visit such places.

The notice lists places where smoking should be totally prohibited in principle: public facilities such as schools, government offices, hospitals and social welfare facilities; entertainment facilities such as theaters, museums, game centers and outdoor sports facilities; commercial facilities such as department stores, shops, banks, restaurants and drinking places; public transport facilities such as bus terminals, airports and ferry terminals and railway stations. Trains, buses, taxis, ships, aircraft, hotels and offices are also listed.

The notice says that measures to prevent secondhand smoke should also be taken in outdoor places where children are expected to gather.

At the same time, it says that in places where a total ban on smoking is “extremely difficult,” appropriate measures to prevent secondhand smoke should be pursued in view of the structure of the facilities and the needs of users. It says measures must be taken to prevent tobacco smoke from a smoking area from entering a nonsmoking area.

Although the notice has no coercive power, a total smoking ban should be carried out in such places as hospitals, government offices, schools and public transport. Companies also should take steps quickly to protect employees from secondhand smoke. A 2007 health ministry survey shows that 56 percent of the polled suffered from secondhand smoke at workplaces.

There is resistance to a total ban on smoking from operators of drinking places and inns and hotels where drinking parties are held. But they should be aware that there are many customers who do not want to be exposed to tobacco smoke.

Importantly, the notice underlines the need to disseminate information on health damage from tobacco based on evidence. It also calls on smokers to be aware that they are exposing other people to tobacco smoke. Health minister Akira Nagatsuma said that after judging the effects of the notice, the government will decide whether stronger steps are needed. Ideally, heightened public awareness will lead to the proliferation of smoke-free places.

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