Cheap, legal and lethal

In the 16th century the habit of smoking tobacco was introduced into Japan by Portuguese traders. Smoking was prohibited in 1603 but the law was ignored. Stricter laws followed in 1607 and 1609, making cultivation of tobacco illegal. Property of tobacco sellers could be confiscated. At least 150 people were arrested in 1614 for buying and selling it. Despite the harsh penalties the ban against tobacco proved unenforcable. When the shogun's own soldiers were found to be smoking it, the shogun realized that prohibition doesn't work. The ban was revoked in 1625. Since then tobacco has been a legal drug that is taxed for public revenue.

See also:
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The average cigarette consumption in Japan in 1996 was 2669 cigarettes for every man, woman and child in the country, second only to Greece. [1] The one third of the Japanese population that smokes buys 900 million cigarettes every day, making Japan the third largest tobacco market in the world after China and the US. Between 50-60% of Japanese men are smokers, one of the highest rates in the world. While other countries have steeply increased tobacco taxes to encourage smokers to stop, in Japan a pack of 20 cigarettes still only costs 230-260 yen, the lowest price amongst major industrialized countries.

Habit Forming The smoking habit has made major inroads among Japan's young adults. Of those in their 20s, 60.9% of men and 16.9% of women smoke, higher rates than among any other 10-year age span. Of male smokers ages 20-29: 6% smoke more than 2 packs a day, 65% 1-2 packs a day, 29% less than 1 pack a day Of female smokers ages 20-29: 1% smoke more than 2 packs a day, 35% 1-2 packs a day, 64% less than 1 pack a day. Source: Japanese Ministry of Health Los Angeles Times, May 17, 1997

Children and adolescents can buy cigarettes from automatic vending machines that can perform no age check, even though selling cigarettes to minors is against the law. 360 million cigarettes a day are sold from unattended vending machines. The vast majority of smokers get started before the age of 19. There are an estimated 924,000 under-age tobacco smokers who are illegaly sold cigarettes. A study by the Ministry of Health and Welfare suggested that according to WHO criteria 18 million Japanese are drug-dependent on nicotine, 54% of all Japanese smokers.

Cigarette packs only carry the following mild warning: "Be careful of how much you smoke such as not to damage your health". Unlike in Europe or the USA no mention of cancer or other fatal diseases is made, even though the risk of developing lung cancer is ten times higher for smokers than for non-smokers and some 80% of lung cancer victims are smokers or former smokers. Efforts by the Ministry of Health and Welfare to strengthen warnings were defeated due to stiff resistance by the powerful Ministry of Finance.

In the past the leading cause of death from cancer in Japan has always been stomach cancer. In 1989 about 49,000 Japanese died from stomach cancer versus 36,000 from lung cancer. Since then stomach cancer deaths increased only marginally but lung cancer deaths have been rising steadily, at a rate of an extra 1500 deaths every year. In 1998 there were 50,477 deaths from stomach cancer but 50,460 deaths from lung cancer. [2] The steadily increasing lung cancer death rate is the long-term effect of the steep increase in smoking that occured amongst Japanese men in the 1960s, when cigarette smoking gained popularity amongst increasingly wealthy Japanese. It is expected that lung cancer will be the leading cause of cancer deaths in Japan by the year 2000, and lung cancer is not the only type of cancer caused by cigarette smoking. Furthermore, figures from other countries suggest that cardiovascular diseases caused by cigarette smoking kill three to four times as many smokers as smoking-induced cancer.

Follow the money

A recent panel by the Ministry of Health and Welfare to study the problem included four representatives of the tobacco industry. This is because in Japan tobacco really does not falls into the domain of the Ministry of Health and Welfare but the Ministry of Finance, which by law must own 67% of all shares of Japan Tobacco (JT). JT holds about 80% of the domestic market. Until April 1998 tobacco advertising continued on Japanese television, even though in the USA cigarette commercials on broadcast TV were banned as early as 1971. In Japan it is still technically legal and JT still advertises on TV, but without showing cigarettes or mentioning any of its brands. Japan Tobacco sells one in every twenty cigarette packs worldwide and its Mild Seven was the second best selling cigarette brand worldwide, outsold only by Marlboro by Philip Morris. Tobacco taxes from annual sales of about ¥ 4 trillion (about US$30 billion) provide for about 1% of all public revenue. While smokers are addicted to nicotine, politicians are addicted to money. Former health minister and prime minister Hashimoto, himself a chain-smoker, once publicly stated that he smokes "as much as possible without damaging my health" because tobacco taxes are an important source of public revenue.

Little protection for non-smokers

Few Japanese restaurants are separated into smoking and no-smoking zones. Smoking is common even in many hospitals. In the offices of the Ministry of Health and Welfare smoking is only banned on the annual international no-smoking day. A few years ago a motion at IATA to ban smoking on all flights worldwide was killed by Japanese opposition. Smoking was not banned on international flights operated by JAL and ANA until April 1, 1999.

Health care costs

A 1997 study published by the Japanese Health and Welfare Ministry puts the bill for smoking related costs at close to ¥ 4 trillion a year. The ministry, long powerless in its battle on smoking policy against the Ministry of Finance, has come up with this study in order to demonstrate that even in financial terms it does not make sense to promote smoking.

According to the study medical costs account for more than a quarter of this amount. The study estimates medical costs for those aged 40 or over who have suffered illness through smoking. It also estimates loss of income due to people in the same age group dying through diseases caused by smoking. The estimates are based on the ministry's fiscal 1993 survey of patients, which includes factors such as the number of days patients were hospitalized. The study covers eight types of smoking-related diseases, including cancer, cerebral paralysis and heart disease. The study estimates the percentage of diseases caused by smoking and their medical costs, using data comparing smokers and nonsmokers. For example, it shows that 20.6 percent of cancers are linked to smoking, the costs of which reach ¥326.7 billion annually, and 18.7 percent of hypertension-related diseases are traced to smoking, the costs of which reach ¥297.8 billion annually. The total medical costs of diseases caused by smoking amount to ¥1.224 trillion. National income lost due to death through diseases caused by smoking amounts to ¥2.63 trillion, including future income loss. Smoking costs society a total of ¥3.907 trillion, according to the study. A ministry official in charge of community public health and health promotion said that loss of national income due to smoking means loss of tax revenues, and the percentage of medical costs caused by smoking out of the total annual medical expenditure is not small. "I would like smokers to be conscious that smoking not only affects the smoker and his or her family but also society as a whole," the official said. see Japan Times November 4, 1997

Cigarette smoking in Japan and the USA

The USA is not only a major tobacco producer and exporter, it is also a major consumer and the problems caused by smoking have been studied there for a long time. Tobacco is easily the biggest killer in that country as its effects kill about as many Americans every week as all illegal drugs combined in an entire year. Tobacco-related diseases kill some 400,000 Americans per year, 1000 every day. Though the health effects of tobacco also depend on people's diet and genetics, this should nevertheless give us an idea of the magnitude of the problem in Japan, which has 47% of the population of the USA but smokes 69% of the number of cigarettes smoked in the USA. It is not unreasonable to assume that around 200,000 Japanese per year may die from the effects of smoking tobacco. Getting people to cut down on smoking would have a far bigger effect on public health than any other change in the Japanese drugs policy.

"When we are pleading with foreign governments to stop the flow of cocaine to our shores, it is the height of hypocrisy for the US to export tobacco."

Dr. Everett Koop
US Surgeon General

Tobacco and other drugs

The United States expects Japan to follow its drug prohibition and enforcement policy ("War on Drugs") but its own priorities are misdirected too. In the US 98% of all drug deaths are from legal drugs such as tobacco and alcohol. Despite this, while the US federal government spends $17 billion per year on measures targeting illegal drugs, only a tiny fraction of that amount is used to combat problems caused by alcohol and tobacco. It spends as little as $1 million per year on anti-smoking campaigns, versus the $4 billion advertising budget of the tobacco industry. Money spent on arresting drug users should be used on educating the public about the risks of all drugs, including tobacco and alcohol, as well as about other health issues such as a healthy diet and getting enough exercise.

See also:
Marijuana smoke vs. Tobacco smoke.
99/12/01 - 33.6 million Japanese smoke
99/09/14 - JT tobacco giveaway on Aged Day
99/05/08 - New Scientist: The lesser of two evils
99/04/14 - Airlines OK cockpit smoking

Footnotes:
[1] See Wall Street Journal, June 23, 1997, page B1
[2] Asahi Shimbun, April 3, 1999

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