Purpose: To evaluate the current status and performance of Japanese outpatient offices for passive smoking patients.

Method: A questionnaire survey about passive smoking diseases in medical outpatient office setting was conducted in 79 clinics.

Results: 48 clinics answered the questionnaire with a response rate of 60.7%. The total number of examinees was 1,399, and the total number of patients per clinic ranges from 0 to 486. Three outpatient clinics opened before 2004, and the other 45 clinics after 2005. 2005 was the year in which the criteria to detect passive smoking diseases was announced, and thereby 15 clinics opened between 2005 and 2006. Another significant increase can be observed between 2010 and 2011 with the opening of 10 clinics. Possible reasons for this increase are the petition made by the Japan Society for Tobacco Control to the Prime Minister to demand legislation targeting the prevention of passive smoking in March 2010 as well as the notice about the prevention of passive smoking by the director of the Insurance Bureau at the Ministry of Health, Labor and Welfare on February 25, 2010. The main reason for their establishment, raised by most clinics, was to help patients who suffer from passive smoking diseases. In regard to the services offered, 37 out of the 48 respondent clinics issue medical certificates. 18 of them additionally mention the violation of Article 25 of the Health Promotion Law as the major cause of the diseases. 10 of them offer follow up observation. 17 of them offer mental care.

Conclusion: According to the Japan Society for Tobacco Control, there are 81 medical institutions in Japan that offer outpatient care for passive smoking diseases. However, only a few of them are operational. In addition, the number of examinees is still small despite the increase in the number of outpatient clinics. Therefore, the introduction of a standard procedure manual for the outpatient clinics treating passive smoking diseases is crucial in order to standardize and enhance the operation of the existing clinics, as well as to promote the opening of new clinics.