Fighting Smoke & Mirrors: Matsuzawa Shigefumi

People can choose to smoke. And people do. But those who don’t smoke want to be protected from it. The movement is spreading around the world and former Kanagawa governor Matsuzawa Shigefumi is at the forefront of it in Japan.

When you were the governor of Kanagawa Prefecture, you enacted several ordinances to stop second-hand smoke. Can you please tell us about that?

In 2005, WHO (World Health Organization) launched the Framework Convention on Tobacco Control. Japan was a ratifying country. Article 8 states that you must make all public facilities non-smoking to protect against second-hand smoke, further providing that governments should enact binding laws with punitive measures. Japan, however, made no progress on enactment of such laws. In my second term as governor, I established such ordinances in Kanagawa prefecture. According to a public survey, roughly 80% of citizens supported a ban on smoking in public places. But when we actually tried to enact that, we encountered fierce opposition from those with tobacco ties—from smokers or operators of private-sector business, for example. Schools, health and welfare centers, and government offices are public and they could stomach that. But some business owners were very opposed, saying that if we make them smoke-free then customers will dwindle and business will be rough. And yet, if you don’t make those places non-smoking, too, then you don’t have a system that protects against second-hand smoke. Japan is in fact the furthest behind among all countries that are enacting smoking legislation under WHO’s guidelines. I wanted to take that first step as the Kanagawa governor. Debate in the assembly was heated but I was nevertheless able to pass the ordinances. Kanagawa prefecture was the first and just this past April, Hyogo prefecture became the second. Unfortunately, in Osaka the assembly was against it and the governor there withdrew the proposed ordinance. But even if you enact ordinances at the prefectural level, that creates prefectural cross-border issues. Take pachinko players, for example. If Kanagawa is non-smoking, they will cross the Tamagawa River into Tokyo where they can smoke and all the business goes with them. For reasons like that I think the law needs to be a national one. I believe that if Japan wants to protect against second-hand smoke nationwide, it absolutely must enact a second-hand smoke prevention law that prohibits smoking in public places.

While you certainly managed to pass second-hand smoke ordinances in Kanagawa, in reality it seems like it came with a lot of compromise since restaurants merely divide sections according to smoking and non-smoking. Exactly what kind of laws are you envisioning?

Making public buildings completely non-smoking isn’t entirely realistic. The issue is in asking people to smoke outside the rooms. I want public facilities to be either completely non-smoking, or completely partitioned. For the latter, buildings should create a separate smoking room or some other suitable location. Guests thus won’t be able to smoke at a restaurant while eating. We have to ask them to go to a smoking room. WHO wants a complete smoking ban but in Japan’s case, you have restaurants inside buildings where guests would have to take elevators to go outside to smoke, and that’s a hard sell. I think having smoking rooms in restaurants is a fair compromise.

You went on a robust publicity campaign to enact these laws. What kind of hard examples or data did you provide to show links between tobacco and health risks?

I think that you first have to reduce the total number of smokers to reduce second-hand smoke. So I talked about the damage that tobacco causes to your health. I also think it’s necessary that people understand that second-hand smoke also damages others’ health. I think you have to have people then understand that in order to protect the health of citizens, you have to have clear laws regulating smoking. We know that tobacco is a major cause of heart disease, internal bleeding, strokes, cancer and chronic obstructive pulmonary disease in particular. If we stay on this course then health care costs will naturally rise. If we regulate tobacco and take the long view, then patients suffering illnesses caused by smoking will decrease concomitantly with health care costs. Tobacco regulation is the most effective means of preventative medicine. I often hear the criticism that if we reduce cigarette taxes then tax revenues will decline, but even if they do, from a long-term perspective, healthcare costs will decrease. Financially, it’s actually a winning situation so I try to explain it from a financial perspective, too.

As for the economics, when we interviewed former Minister of Health, Labor and Welfare, Komiyama Yoko, she mentioned raising the price. Do you think that’s effective?

Yes, I do. This is also one of WHO’s framework objectives. Cigarettes are about ¥400 a box in Japan. Raise that price to ¥1000 and the number of smokers will decrease. Underage smokers in particular won’t be able to afford them. But while you may decrease the number of people purchasing tobacco by raising the price to ¥1000, the tax on each box increases. So in the big picture, tax revenues do not decline at all. The tobacco industry here just doesn’t get this. Overseas, there are tons of examples proving it. It’s like killing two birds with one stone. Raise the price of tobacco and you decrease the number of smokers and have a healthier society, and revenues do not decline. There’s no economic loss. And this is great policy. But now comes the big problem. Japan differs from other countries in that the tobacco industry is a kind of socialist system. There is a law called the Tobacco Industries Act that falls under the supervision of the Ministry of Finance. The purpose of this law was to stimulate the tobacco industry and establish sound finances and economy. It’s basically a law that says, ‘let’s smoke tobacco, increase the tax revenues and boost the economy.’ But this law didn’t consider health whatsoever. Tobacco administration would normally fall under the supervision of the Ministry of Health, Labor and Welfare. In other countries the division of the government that monitors health manages tobacco, but in Japan it’s the Ministry of Finance, which generally manages taxes. This is the biggest problem in Japan. Another is that we have the JT Act (Japan Tobacco, Inc. Act) whereby JT controls the production of tobacco here. Overseas tobacco companies cannot produce cigarettes here even though they can sell them. That’s socialist. They buy up every last leaf grown by tobacco farmers. The Ministry of Finance and JT also control distribution, only selling at stores that have received permission to do so. Elsewhere around the world, tobacco markets are competitive. But because of Japan’s tobacco laws, JT controls everything from tobacco farming to distribution, completely stymying capitalism. You really can’t call this anything other than a socialist economic system. The cause is the high cost of producing tobacco in Japan. If we don’t destroy these tobacco concessions created by the Ministry of Finance, JT, tobacco farmers and tobacco distributers, then Japan’s efforts to create tobacco regulations in line with WHO’s guidelines will not move forward. So while our initial goal is to enact a law in the national Diet that protects people against second-hand smoke, in the future I think we have to scrap the law that gives jurisdiction of tobacco to the Ministry of Finance, transfer it to the Ministry of Health, Labor and Welfare, and then pass regulatory laws that conform with the tobacco regulatory framework in WHO’s convention. We need to abolish JT’s control of production and return to a capitalist system that competes with world markets. I believe that there’s a chance this will be adopted as a part of the Trans-Pacific Partnership (TPP). America has pointed out that the partially state-owned enterprise that has a stake in the Japan Post Office (JP) is oppressing private sector business. It’s the same with tobacco. The only two countries protecting the tobacco industry on a national level like this are communist China and capitalist Japan. If we don’t have complete reform of tobacco concessions, then Japan’s tobacco regulations will never reach international standards. If Diet members are serious, they can absolutely enact these reforms.

If the prefectural administrative reform proposal (where more power from the central government will revert to prefectures) passes, then it would seem that discussions on tobacco regulations would proceed rather quickly on the prefectural level, correct?

There’s going to be some big hurdles to that in Japan, I imagine. There are many influential politicians working to protect tobacco interests in Japan. There are parliament members who win their electoral districts through the power of tobacco farmers, there are those who receive support from tobacco retailers, and then there are those who receive support from JT’s unions. And, well, I guess this is probably true of most Diet members, but there is everyone who relies on the Ministry of Finance, too, for their budget money. I bet they are all against any kind of reform that would harm their interests. Reform is a bad thing. People with my ideas are treated as weirdoes. Nevertheless, I think we are most behind the times with regard to tobacco regulations when compared to other developed countries. Even China passed ordinances to protect against second-hand smoke in Beijing when they hosted the Olympics. Right now I think that the only countries that don’t have national laws regulating tobacco are Japan and North Korea. I think this problem will affect our Olympic bid. WHO and IOC cooperate. Sports festivals and the Olympics should be held in healthy cities. And thus cities that have recently hosted the Olympics have laws to protect people against second-hand smoke. Again, even China, the supposed tobacco kingdom, passed laws for the Beijing Olympics. And in Russia, too, another big tobacco country, Putin passed a law this year to regulate tobacco in anticipation of the winter Olympics. Tokyo mayor Inose would like to host the Olympics, but he’s avoiding passing these regulations. We won’t win the bid like this. When I ran in the last Tokyo mayoral election, I fought with this in mind. I believe that this is a condition of being able to win the Tokyo Olympics. And if Tokyo is not willing to do anything about it, then the national government must enact regulations.

It’s been about three years since Kanagawa enacted the ordinances that protect against second-hand smoke. Do you have any hard data on the economic or health effects of that?

We can’t very well obtain accurate health data if only Kanagawa is involved. That’s because people move around, going to Tokyo for work or school or shopping, for example. And Tokyo, with no ordinances, is a place where people can smoke freely. To get real health data Japan as a whole needs to do it, not just Kanagawa. Collecting sufficient data will also probably require about ten years. Ireland and Scotland were the first to pass tobacco regulations, enacting them in 2003. Now, after ten years, they are seeing a drop in the number of people who are being rushed to the hospital for heart attacks—that’s likely a result of the tobacco regulations. In another ten years, I think we’ll start to see data coming out indicating that there is also a decrease in emphysema as well as arterial and brain illnesses. In Europe, the number of victims of heart attacks is decreasing. As far as economic data is concerned, Kanagawa prefecture does seem to be collecting it. There was a brief period when customers dwindled because of the anti-tobacco ordinances. That happened in Europe and even in Irish pubs as well. I went to investigate it myself. But the Irish love pubs, don’t they? And so the customers came back. Now there’s a system where, when they smoke, they do it outside and when they are done, they come back in. Air inside the bars cleared up. For the first six months, sales were down, but then rebounded—so I think we can say there are no problems. Overseas, establishments where people enjoy alcohol are mostly on the ground level, but that’s just not the case for bars in Japan. If you’re on an upper floor of a building, you have to take the elevator and then come back. It’s a pain for customers. If they don’t like that, they won’t ever come back. There are many cases of opposition when the economic blow is as serious as that. Actually, the smaller the place, the higher the danger of second-hand smoke. But if we make exceptions for places like these, then the law becomes arbitrary. You’d have the law but no results and so I think we have to have an across the board ban on smoking in bars and restaurants. Then you have entertainment facilities. In Europe you have casinos and in Japan you have pachinko and mahjong. You’re in there for a long time. There’s quite a lot of people demanding, ‘let me smoke.’ With the Kanagawa ordinances, we had a really tough fight with establishments regulated under the adult entertainment laws. But pachinko parlors in Kanagawa built smoking areas. They divided smokers by floors and cooperate in that manner. I think we need to have such tactics during the transition period.

What other kinds of education or measures are you taking to reduce the number of smokers?

Price increases, first of all. Raise tobacco taxes and it will raise the price of the tobacco. Nicotine is addictive and so quitting isn’t easy. But in Japan now you can use your insurance to receive treatment. There is the view that with tobacco, patients have an actual “nicotine addiction disease.” To overcome that, you can use insurance. You don’t have to suffer alone; you can go to the hospital, talk to a doctor and receive treatment (like patches) to fight the addiction. In Kanagawa, we have a “tobacco school” where people can receive information. And then there’s education. We teach how very large the risks are to your health. We start with the realization that underage smoking actually begins in middle school—rather than target high school kids, we target them. Doctors and health practitioners visit the classrooms to teach them about the harmful effects of tobacco on health. Cigarette sales from vending machines are also a problem. The only two developed countries in the world that allow cigarettes to be sold from vending machines are Germany and Japan. We have Taspo cards in Japan to verify age at vending machines, but they’re not very effective. Kids can borrow a card from someone. And the very existence of those vending machines is like an advertisement. This is all in violation of WHO’s Framework Convention on Tobacco Control. Tobacco must only be purchased directly and cannot be sold to minors. That kids here can buy tobacco so easily is a problem. When we start creating tobacco regulations, it’s also going to be necessary to tackle this problem.

(interview & translation: Ry Beville)



2005年にWHO(世界保健機関)が、たばこ規制枠組み条約(FCTC: Framework Convention on Tobacco Control)をスタートさせました。日本も批准国です。この条約の第8条は、受動喫煙を防止するために公共的な施設は禁煙にしなければいけないというもので、罰則があり強制力のある法律を制定することを指針としています。ところが日本では法律の制定に進みませんでした。そこで私の知事としての2期目に、神奈川県の条例として成立させました。世論調査では、約80%の人が公共の場所での禁煙に賛成をしました。しかし、実際に条例をつくるとなると、たばこに関係のある人たちは猛反対しました。例えば、スモーカーの人や民間の営業施設の方たちです。学校や福祉施設、役所は公的機関なので禁煙でも納得するんですね。民間の営業施設で禁煙にするとお客さんが減り、経営が厳しくなると大反対されるのです。しかし、そういう場所でこそ受動喫煙を防止しないと、受動喫煙防止の体制になりません。諸外国では、条約に基づいて禁煙の方向に動く流れの中で、日本が一番遅れています。私は、まず神奈川から始めようと考えました。議会との交渉も大変でしたが、どうにか条例を成立させることができました。神奈川県で条例ができて、兵庫県が全国で2番目として今年の4月からスタートしました。残念ながら、大阪府は議会の反対を受け、知事が条例案を取り下げました。県単位で条例を制定しても、県境問題が起きます。例えばパチンコをしているお客さんが、神奈川県では禁煙、玉川を渡った東京ではたばこが吸えるとなると、東京にお客さんが流れてしまう。ですから、これは日本全国で法律としてやるべきです。私は日本全国で受動喫煙を防止するために、公共の施設は禁煙にするという受動喫煙防止法を制定しなければならないと考えています。





経済的な話として、前厚生労働大臣 小宮山洋子氏に以前にインタビューした際、たばこの値段を上げる案についてお話しくださいました。そのことについて、松沢さんはどのように捉えられていますか?










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