Secondhand Smoke Exposure in Public Places and Support for Smoke-Free Laws in Japan: Findings from the 2018 ITC Japan Survey.

Genevieve Sansone,Lorraine V Craig,Geoffrey T Fong,Itsuro Yoshimi,Gang Meng,Anne C K Quah,Yumiko Mochizuki,Janine Ouimet,Steve S Xu,Takahiro Tabuchi

doi:10.3390/ijerph17030979

Abstract

Comprehensive smoke-free policies such as those called for by the WHO FCTC are the only way to protect the public effectively from the harms of secondhand smoke (SHS), yet Japan has been slow to implement this important health measure. This study examines baseline levels of smoking and SHS exposure in public places and support for smoking bans in Japan prior to the implementation of the 2018 national smoke-free law. Data are from the International Tobacco Control (ITC) Japan Wave 1 Survey (Feb–Mar 2018), a web survey of adult cigarette smokers, heated tobacco product users, dual users, and non-users (total N = 4684). Measures included prevalence of smoking (whether respondents noticed people smoking inside restaurants and bars at their last visit, and workplaces in the last month), and support for complete smoking bans in these venues. Smoking prevalence in each venue was high overall in 2018 (49% of workplaces, 55% of restaurants, and 83% of bars), even higher than in China, the country with the greatest toll of SHS. Support for complete smoking bans was very high overall (81% for workplaces, 78% for restaurants, and 65% for bars). Non-users were less likely to be exposed to SHS and had higher support for smoking bans than tobacco users. These findings point to the ineffectiveness of partial smoke-free laws in Japan and reinforce the call for comprehensive smoke-free laws, which even smokers would support at higher levels than in many other ITC countries.

Highlights

Secondhand smoke (SHS) is a significant threat to health, estimated to have killed 1.22 million people globally in 2017 [1]
Because the cross-sectional weights were calibrated to the population numbers of each of the mutually exclusive user groups, crossed with the 8 geographical regions of Japan, sex, and 4 age groups of the population of Japan aged 20 years and above, these weighted percentages of observed smoking can be taken to be national estimates of smoking prevalence in each of the three venues in Japan
This study shows that the lack of strong smoke-free laws in Japan has led to extremely high rates of exposure to deadly secondhand smoke (SHS) in public places

Summary

Methods

Data are from the International Tobacco Control (ITC) Japan Wave 1 Survey, a web survey of approximately 4500 adults aged 20 and older across 8 geographic regions of the country, who were recruited by email from Rakuten Insight’s Japan web panel. All respondents gave informed consent before participating in the study, and the survey methods and materials were approved by the University of Waterloo Office of Research Ethics (ORE #31428). The Wave 1 Survey sample was designed to be representative of adult cigarette smokers, HTP users, dual users, and non-users within each region. Note that in this study, “smokers” refers to those who smoke cigarettes (either cigarettes only, or dual users of cigarettes and HTPs; excluding HTP only users). Smokeless tobacco product users were not included in the study. For a more detailed description of the ITC Japan Survey methods, see the technical report at the following website: https://itcproject.org/files/JP1-1.5_Technical_Report_28Feb2019_FINAL.pdf/

Results

Discussion

Conclusion