No one says passive smoking is good for you, but just how bad is it? The answer is vital in deciding public policy.
If it is just a matter of manners, smokers and nonsmokers should compromise, albeit with smokers giving most of the ground. On the other hand, if passive smoking is a health hazard then public policy must take an uncompromising stand.
With the 2020 Tokyo Olympics coming up, the government is dithering over the extent to which restrictions on passive smoking — now toothless — should be beefed up. This has been widely reported, including coverage in this newspaper. What’s missing though is a clear consensus on the reasons for strengthening the regulations.
Decisive information is available on the home page of the Health, Labor, and Welfare Ministry. A research team from the National Cancer Center Japan found that passive smoking causes about 15,000 deaths a year in Japan, which is about four times the death toll for traffic accidents here (3,694 last year). The NCCJ estimate was made using best practices of epidemiological research and has not been challenged by subsequent scientific research. When adjusted for population, the NCCJ figure is in good agreement with the estimate of 40,000 passive smoking deaths per year in the U.S. published by the U.S. Centers for Disease Control and Prevention.
I asked the Cabinet Office how it views the NCCJ figure but was told it had no one who could answer and was referred to the health ministry. The health ministry’s spokesman said that while they were of course aware of the NCCJ research it was just one of many items to be taken into account in determining government policy on passive smoking. He said that other factors included complaints from bar and restaurant owners that strong passive smoking regulations might reduce their profits.
So, this is where we are: 15,000 people a year are killed by passive smoking, but they are distributed throughout the populace, the harm accumulates a little at a time, and most deaths occur many years after the exposure to passive smoking. Public outrage about passive smoking is not widespread — there are no massive public protests. On the other hand, smoking regulations would have an adverse economic impact on the tobacco industry and bar owners right now, so they fight tooth and nail to protect their income.
Of course it’s easy to point to many other similar examples where strong financial interests trump the public good: the success of gun manufacturers in the U.S. in stymieing regulations on assault rifle sales despite repeated mass shootings is a classic example. Tobacco manufacturers in every country in the world — not just Japan — are fighting to stave off or delay regulations. But Japan’s tobacco industry has been more successful in delaying and defanging regulations than tobacco interests in any other developed country. Let’s look at the tricks it uses.
Japan’s tobacco interests have the best advertising and public-relations people on their side, and brilliantly exploit human psychology. Using fixed-price meals in Japanese restaurants as a metaphor, there are usually three choices, listed in order of increasing price. Restaurateurs know that most people will pick the middle option. In this case the options available to the government are doing nothing, compromising and adopting real regulations with teeth. Given the strong pressure from health advocates and international opinion on one hand, and from the tobacco interests and their political allies on the other, it is, alas, natural for the government to pick something in the middle.
The PR genius of the tobacco interests is in their framing of the middle option, which they call “bun-en.” According to Wikipedia, this word first appeared in print in Japan only in 1985. It has no English counterpart but can be explained as follows. “Bun-en” means the division of a space into separate smoking and nonsmoking areas. The pitch is that this will mitigate the hazards of passive smoking.
But in many cases the barrier between the smoking and nonsmoking areas is just a wall with an unsealed top and bottom, allowing smoke to pour over and under freely. Even if there is a sealed smoking box, as at airports, smoke leaks out whenever the door is opened, and smokers leave a trail of cancer-inducing micro-particles in their wake.
So the health benefits of bun-en, if any, are negligible. The sole advantage of bun-en is that encouraging it allows the government to pretend it’s taken some anti-passive smoking action, whereas of course it really hasn’t.
Another PR tactic of Japan’s tobacco industry is the weaponization of vacuous TV commentators who can say almost anything as an opinion, whether or not their claims are backed up by science.
For example, the talking heads can be pre-programmed to describe the NCCJ estimates of the death rate for passive smoking as “just statistical analyses that I don’t believe,” or the like. The tobacco companies themselves couldn’t get away with making such absurd statements, but their stooges can.
Of course such statements don’t actually disprove results from epidemiology, but they help to create enough doubts to keep the bun-en scam rolling along.
In theory, Japan’s media should be taking the lead in the campaign against passive smoking. But the legacy media — both print and electronic — are in bad financial shape. Ads bought by tobacco companies — including their non-tobacco subsidiaries — tend to damp down media enthusiasm for vigorous anti-smoking campaigns. NHK is an independent public broadcaster, but, as everyone in Japan knows, its programs tend to conform closely to government positions.
The only way to break the logjam is to hold the government’s feet to the fire. Reporters and Diet questioners should demand that the prime minister clearly state whether or not he accepts the NCCJ estimate of 15,000 passive smoking deaths every year. If he says “no,” he should be forced to cite specific scientific research backing up his position. If he says “yes,” he should be forced to state clearly and in detail what he’s going to do to effectively clamp down on passive smoking.
The ruling Liberal Democratic Party says it aims to protect the lives and property of Japan’s population. Talk is cheap. Let’s see the LDP prove it means what it says by taking effective measures to crack down on passive smoking.
Robert J. Geller is a professor emeritus (seismology) at the University of Tokyo, where he taught from August 1984 until March 2017.
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