[Intl-tobacco] Key anti-tobacco targets in health project go up in smoke (fwd)

[Robert Weissman]

EDITORIAL: Key anti-tobacco targets in health project go up in smoke
In the end, however, the `realists' prevailed, holding that it was inadvisable to set targets that were certain to provoke oppos
Source: Asahi Shimbum, Sunday, 2/27/00

     Bowing to pressure, the Health and Welfare Ministry has practically
 given up plans to protect the public's health. The ministry aimed
 to halve the number of adult smokers and the per-capita volume
 of tobacco consumption by 2010 under the ``Healthy Japan 21''
 project. But it was forced to drop these targets amid strong
 objections raised by the tobacco industry and the farm lobby
 of the ruling Liberal Democratic Party.

     The target of protecting the health of the people has been scuttled
 as a result of the move.

     With the specific goals dropped, the project calls for such
 alternative anti-smoking efforts as ``dissemination of knowledge,''
 ``making a thorough distinction between where people can and
 cannot smoke,'' and ``promoting programs to help people stop
 smoking to the point where they can receive assistance anywhere.''

     These are all important tasks, but they are just the means to
 accomplish goals. They do not fit in with the project's numerical
 targets.

     The ``Healthy Japan 21'' project is supposed to guide the nation's
 health movement in the 21st century. Creators of the project
 have spent a year and a half working out numerical targets to
 be attained, with a strict reassessment scheduled 10 years from
 now.

     The project's specific targets include: reducing the rate of
 those who do not eat breakfast to 15 percent or less among men
 in their 20s and 30s; increasing the average number of steps
 taken by adults by 1,000 a day to 9,200 for men and 8,300 for
 women; reducing the number of heavy drinkers-those who consume
 more than the equivalent of three go of sake a day (one go
 equals 0.381 U.S. pint)-by more than 20 percent; ensuring that
 more than 60 percent of the population will eat fruit every day;
 and increasing the average daily intake of vegetables to more
 than 350 grams.

     Lifestyles are basically a matter for each individual to decide.
 The targets have been worked out to provide reference material
 to help individuals make their choices, presupposing assistance
 from public agencies to translate them into reality.

     The implication is that if there are fewer sick people, it would
 not only help them as individuals but also spare the government
 a hefty increase in health insurance expenditures.

     Starting about 20 years ago, the world has seen a shift in the
 thrust of public health policy from ``disease prevention'' to
 ``health enhancement.''

     It is a common perception among industrially advanced countries
 that to realize this target, efforts by individuals to reform
 their lives must be combined with governmental initiatives to
 improve the social environment.

     Based on this view, the United States, Britain and Canada have
 drafted health enhancement strategies. The tide induced the Health
 and Welfare Ministry to work out the ``Healthy Japan 21'' project,
 the first target-oriented program of its kind in this country.

     The project's numerical targets to curb obesity, high blood
 pressure and other health risks are designed to keep people under
 65 alive and reduce the ranks of the elderly who become disabled
 by the aftereffects of sickness.

     Halving the smoking population and the consumption of tobacco
 was to be the centerpiece of these targets. Reducing the number
 of smokers is known to hold the key to curbing cases of cancer,
 heart disease, cerebral stroke, stomach ulcer, and duodenal ulcer.

     Common wisdom around the world holds that banning smoking is
 the most effective way for an industrially advanced country to
 trim its medical expenses.

     During deliberations by a government panel that wrote the project,
 members who had been helping people kick the smoking habit argued
 that it was absolutely necessary to set easy-to-understand and
 impressive numerical targets.

     In the end, however, the ``realists'' prevailed, holding that
 it was inadvisable to set targets that were certain to provoke
 opposition. They said it was more important to make sure that
 the anti-smoking campaign would bear fruit.

     There is no question that these realists were spurred on by
 tobacco growing farmers, the government agencies attaching importance
 to the revenue from cigarette sales-the Agriculture, Forestry
 and Fisheries Ministry and the Finance Ministry-and the tobacco
 lobby in the Diet.

     Obviously, the vested interests put their short-term gains ahead
 of the health of the people in forcing the Health and Welfare
 Ministry to drop the key anti-smoking goals from the ``Healthy
 Japan 21'' project.

     Japan has yet to make substantial progress toward the fundamental
 anti-smoking measures that are already in place in many other
 countries. Such measures include sharply raising the tobacco
 tax, imposing a wholesale ban on tobacco advertising and limiting
 the installation of cigarette vending machines.