Tobacco Control Lessons from the Higgs Boson: Observing a Hidden Field behind Changing Tobacco Control Norms in Japan

Abstract

Despite the overall theme of this Issue being the future of global tobacco control, this Article is about Japan, with the conscious intention of presenting Japan as a demonstration of a different type of tobacco control environment. To be clear, I am not trying to suggest Japan is an unambiguously positive exemplar for other nations. Rather, it is with the idea that Japan's circumstances might be showing us that things are not always as bad as they might first appear. To quote Mick Jagger and Keith Richards, great philosophers of the twentieth century, “You can't always get what you want, but if you try sometimes, you just might find, you get what you need.”

Changes Over Time in Absolute and Relative Socioeconomic Differences in Smoking: A Comparison of Cohort Studies From Britain, Finland, and Japan

“…50 Japan provides a divergent case as antismoking policies have been weaker or nonexistent, with prevalence levels among men as high as 55% in 1998 declining to 33% in 2012. 51 Our observations on British and Finnish men and women reconfirm the need for further measures that target smoking in general as well as the large and persistent socioeconomic differences. It is well-known that smoking is a key contributor to socioeconomic differences in morbidity and mortality in western countries, 49,52,53 and the persisting socioeconomic differences in smoking suggest that smoking likely contributes to these differences also in the future.…”

Japan Tobacco International: To ‘be the most successful and respected tobacco company in the world’

“…This decline has occurred despite Japan’s limited commitment to tobacco control. Levin ( 2013 , p. 474) argues that the Tobacco Business Act ‘reflects a political economy where tobacco interests have extraordinary control via sympathetic legislators and, more importantly, potent agency protection given by taxation and budgetary bureaucrats in Japan’s Ministry of Finance’. In this environment, the only significant policy developments have been the 2002 Health Promotion Act and Japan’s ratification of the FCTC, which have legitimised the profile of tobacco control and created increased discussion among the public, policy-makers, and in the media.…”

“…In this environment, the only significant policy developments have been the 2002 Health Promotion Act and Japan’s ratification of the FCTC, which have legitimised the profile of tobacco control and created increased discussion among the public, policy-makers, and in the media. These have been augmented by gradual, and contested, tax increases, a small number of administrative measures, and local level smoke-free decrees (Levin, 2013 ).…”

“…In the absence of comprehensive regulation, the drop in smoking rates appears attributable to a combination of the international obligations inherent in Japan’s ratification of the FCTC; the later onset of the tobacco epidemic and related morbidity and mortality, compared to the U.S.A.; the pharmaceutical industry’s promotion of smoking cessation products which signals the entry of another key economic actor into the smoking and health dialogue, and, seemingly, to changes in cultural attitudes to smoking (Levin, 2013 ).…”

“…The Japan Tobacco Incorporated Act of 1 April 1985 established a publicly traded stock company that was 100% government owned until 1994. Government control has since declined to a one-third holding in 2016 (JT, 2009 ; Levin, 2005 ; Levin, 2013 ).…”