The evolution of tobacco control in Japan:

Local governments move to target indoor areas

Kashiwabara M1, Armada F2 and Yoshimi I3
1Consultant,

For more information about

our research on smoke-free cities:

http://www.who.or.jp/smokefree.html

Kobe, Japan; 2World Health Organization Centre of Health Development, Kobe, Japan; 3Tokyo Metropolitan Government, Tokyo, Japan

ACKNOWLEDGEMENTS: We would like to thank Dr Hiroshi Ueda (Osaka University) and the National Institute of Public Health of Japan for their support in carrying out this study.

METHODS

BACKGROUND

Japan has three levels of government (below). In

this study, we focused
A: National Diet of Japan
on subnational,
L: National law/act
National
i.e. prefectural
government
and municipal
A: Prefectural Assembly
47 prefectural
L: Prefectural ordinance
ordinances.
governments

A descriptive case study to

illustrate different types of
Japanese ordinances that
restrict smoking in public
places.4

Japan has national laws such as the Health Promotion Act that include tobacco control provisions and signed the WHO
Framework Convention on Tobacco Control (FCTC) in 2004. However, it falls far short of achieving smoke-free
environments for which effective implementation is required in the WHO FCTC.1 As a result, nearly 7,000 adults (est.)
die annually of lung cancer and heart diseases due to secondhand smoke (SHS) in Japan.2 Meanwhile, subnational
ordinances with potential tobacco control impacts are becoming common an increasing number of
municipalities/prefectures are implementing ordinances on smoking in public places, especially in streets.3

1,727 municipal
governments

Grey literature including

government records and
media reports was reviewed.

This study examines legislation at Japanese subnational level and its relationship to SHS in order to derive evidence on
the role of local governments in promoting smoke-free environments and to guide others considering similar measures.

(cities, towns, villages)

Levels of government bodies in Japan

(A: Legislative authority, L: Law)

RESULTS
1997: The first street smoking ban ordinances were implemented in four cities in the
Greater Tokyo Area: Nerima, Kashiwa, Ichikawa and Toshima

Street smoking bans are the

common measures implemented
by municipal governments in
Japan.3
A wave of ordinances started in
2002 when Chiyoda introduced a
ban with fines, and 112
municipalities had introduced
restrictions on outdoor smoking
by the end of 2009.

A signage on a pavement No smoking

in streets in Toshima City, Tokyo

Healthy Japan 21 is a national health promotion campaign whose main purpose is to prevent
lifestyle diseases.5 The campaign includes four smoking-related goals to be achieved by 2010:

2000: Japan launched Healthy Japan 21 campaign

Awareness raising on health impacts of smoking

Elimination of tobacco use among minors
Promotion of separation of smoking and non-smoking areas in public places and workplaces
Promotion of smoking cessation support programmes

2002: Chiyoda City (Tokyo) introduced penalties against violations of street smoking bans
2003: Japan adopted the Health Promotion Act
2004: Japan signed and accepted the WHO FCTC
2005: The WHO FCTC entered into force (worldwide)

WHO FCTC and

the Guidelines
for
implementation

World Health Organization Framework Convention on Tobacco Control (WHO FCTC) was
introduced to counter tobacco epidemic in the world by providing a set of provisions both on
the tobacco production and consumption sides. With its Article 8, parties are required to
implement effective measures to protect people from SHS for which harmful impacts on
health has been proven by abundant evidence.7 Since Japan is one of the parties, it is bound
to implement measures against SHS in line with the WHO FCTC and its guidelines, i.e. 100%
smoke-free environments in public places.8

2009: Kanagawa Prefecture adopted Kanagawa prefectural ordinance on prevention of

exposure to secondhand smoke in public facilities

2010: Ministry of Health Labour and Welfare of Japan

reaffirmed through an official announcement that
public places should be smoke-free
2010: Kanagawa ordinance came into force (except provisions on penalties)
2010: Hyogo Prefecture established a consultation committee for SHS measures
2010: Chiba Prefecture established a consultation committee for SHS measures
2011: Penalty provisions of the Kanagawa ordinance came into force
2011: Nagareyama City introduced the first municipal smoke-free bill to the city council

CONCLUSIONS

Most of the ordinances were not

motivated by protection from SHS,
but for environmental or
aesthetic reasons, e.g.
prevention of littering and brushby burns.

Article 25 of the Health Promotion Act exhorted

managers of public places such as schools, halls,
hospitals, department stores, public service offices, and
restaurants to implement measures to prevent SHS
exposure to visitors of the premises.6

Complete bans are rare even in

designated no-smoking streets,
and exhortation to refrain from
smoking in streets is the most
common approach.

Since it is an exhortation, it has no legal penalty against

those who do not abide by the provisions, and the
regulations practically rely on voluntary bans.
Although it goes against the WHO FCTC, recommended
measures include physically separated smoking and nonsmoking areas.
The first ordinance to restrict smoking in indoor public
places was adopted by Kanagawa Prefecture, originating
from the then governors manifesto during the 2007
election. Unlike street smoking bans, the ordinance was
under the responsibility of the prefectural health
department and has clear mention on negative health
impacts of SHS.9
Different levels of ban for two categories of public
places were employed (see Table I); however, it has
significant, health-affecting exemptions:
Separation of smoking and non-smoking areas (e.g.
separated seating areas in restaurants)

No-street-smoking zone in Chiyoda City, Tokyo

Type of
buildings

Type I public facilities

Type II public facilities

Schools, hospitals,
sports facilities, halls,
malls, banks,
amusement parks,
government offices

Restaurants, bars, night

clubs, hotels, leisure
facilities (dance halls,
karaoke etc.), any other
hospitality facilities

Prohibition or smoking
Designated smoking areas can be established in any Provision
Prohibition
separation
type of facility
Table I. Categories of public places in Kanagawa prefectural ordinance
on prevention of exposure to secondhand smoke in public facilities

Other prefectures and municipalities are

now moving to enact their own indoor
smoking restrictions. Hyogo Prefecture,
Chiba Prefecture, and Nagareyama City
(in Chiba Prefecture) have launched
local initiatives for smoke-free
legislation (Figure I).
A sign in front of a coffee shop indicating separate
smoking and non-smoking seating areas

Street smoking bans

Street smoking bans

REFERENCES
World Health Organization. (2011) WHO report on the global tobacco epidemic, 2011 - Warning about the dangers of tobacco. Geneva, Switzerland.
The Japan Times (2010) Passive smoking kills 6,800 annually. 29 September 2010.
Ueda, H., Armada, F., Kashiwabara, M., Yoshimi, I. Street smoking bans in Japan: A hope for smoke-free cities? Health Policy 102(1):49-55.
Yin, R.K. (2009) Case study research : design and methods. 4th ed. Los Angeles, CA, USA: Sage Publications.
Ministry of Health Labour and Welfare, Japan. (2000) [Healthy Japan 21 Japanese National Health Promotion in the 21st Century]. Tokyo, Japan.
Ministry of Health Labour and Welfare, Japan. (2003) [Health Promotion Act], 103.
World Health Organization. (2003) WHO Framework Convention on Tobacco Control - Adopted by the Conference of the Parties to the WHO FCTC. Geneva, Switzerland.
World Health Organization. (2011) WHO Framework Convention on Tobacco Control: guidelines for implementation Article 5.3; Article 8; Articles 9 and 10; Article 11; Article 12; Article
13; Article 14 - 2011 edition. Geneva, Switzerland.
9. Kanagawa Prefectural Government. (2009) [Kanagawa prefectural ordinance on prevention of exposure to secondhand smoke in public facilities], 27.

Figure I. Ordinances on street and indoor

smoking bans in Japan

(implementedafter2010)

Indoor smoking bans

Indoor smoking bans
(discussionon-going)

Nagareyama City: The first

municipal-level bill on indoor
public smoking bans was
submitted to the council in
September 2011.

Although no evidence is yet available in terms of the health impact of these ordinances implemented by the subnational governments,
SHS is becoming less socially acceptable in Japan as smoke-free ordinances are becoming popular. The legislation demonstrates that
local governments in a country with weak tobacco control can take the initiative to restrict smoking and that local action facilitates
tobacco control activities in other jurisdictions. Stronger health-based tobacco control policy such as 100% smoking ban is necessary to
provide universal protection to people in Japan, and the past initiatives proved that implementation of such policy is politically feasible.

1.
2.
3.
4.
5.
6.
7.
8.

A: Municipal council
L: Municipal ordinance

Chiba Prefecture:
A committee was
established in 2010
and the local initiatives
in Hyogo and
Nagareyama on indoor
smoking have been
discussed.
Hyogo Prefecture:
A final report of discussions at the
special committee was shared with the
Governor in July 2011. A bill for an indoor
smoke-free ordinance is expected to be
introduced by the end of 2011.

DISCLAIMER
The views presented herein are those of the authors and do not necessarily reflect the decisions, policies or views of
the World Health Organization. The use of particular designations of countries or territories does not imply any
judgement as to the legal status of such countries.

CONTACT INFORMATION

World Health Organization Centre for Health Development

(WHO Kobe Centre)

Address: 1-5-1 Wakinohama-Kaigandori, Chuo-ku, Kobe 651-0073, Japan

Tel: (+81) 78-230-3100
Fax: (+81) 78-230-3178
Email: wkc@wkc.who.int
URL: http://www.who.or.jp/