2020 Volume 69 Issue 2 Pages 103-113
In Japan, health effects of tobacco smoking, including second-hand smoke (SHS) exposure, are comprehensively evaluated in the report “Smoking and Health -A Report of the Evaluation Committee on Health Effects of Smoking” (so called “Tobacco White Paper”) in 2016 (Ministry of Health, Labour and Welfare). The diseases evaluated as “Level 1 (evidence is sufficient to infer a causal relationship)” to SHS exposure are lung cancer, ischemic heart diseases, and stroke in adults. The population attributable fraction of each of these diseases is 1-4% in males and 9-10% in females, corresponding to 15,000 annual deaths in Japan. For childhood, sudden infant death syndrome (SIDS) and prevalence of asthma was judged as “Level 1.” Smoking ban in public places with a penalty is effective and one of the global standards in preventing SHS exposure. Indeed, scientific evidence is sufficient on the reduction of health outcomes of adult, reproductive and childhood health after legislative measures. The world first report on the health effects of SHS exposure was produced in Japan, which led to the global social norm of banning indoor smoking after several decades. The tobacco industry’s interference, in which many scientists have also been involved, is one of the reasons why building the social system was not realize earlier.
