The Land Cigarettes Call Home

Teruo Araki wheezes as he glances down at the oxygen tanks that accompany him everywhere. “This is what smoking did to me,” he says. “And I hold the Japanese government responsible.”

The fist-sized tumor removed from his lung is hardly uncommon in a nation where half the male population smokes. What is rare is the 75-year-old Araki’s willingness to speak out -- and file the first smokers’ lawsuit against Japan’s major tobacco interests.

Japan’s slow-moving wheels of justice are expected to deliver a verdict early next year, five years after the case was filed, in a nation where courts rarely rule against the government. In the interim, three of the seven plaintiffs have died.

In other countries, governments are leading the anti-smoking fight with aggressive health warnings, advertising bans and multibillion-dollar lawsuits. Here, the government is tobacco’s biggest supporter -- and biggest investor.

“The Japanese government cares more about money than people’s health,” said Yoko Komiyama, an opposition lawmaker and leader of a newly formed anti-smoking group in parliament.

Mix in special interests, powerful farm lobbies and a cultural reluctance among Japanese to question authority, and you have the makings of a deeply entrenched killing machine.

Although the rate of tobacco usage is gradually declining, 49% of Japanese men smoke, the highest level in the industrialized world, as do 14% of women. The greatest use by gender is among women in their 20s and men in their 30s, suggesting that the industry’s aggressive courting of young people could reverse the decline.

These days, more voices are criticizing the haze. Bullet trains have reduced their number of smoking cars. A new law gives nonsmokers more rights, and some local governments are imposing smoking restrictions. Tokyo’s Chiyoda district early this month initiated a $16 fine for lighting up on the street.

Still, in a nation known as a smokers’ paradise, there are few limits on puffing away in restaurants, offices, even hospitals. And the issue of secondhand smoke remains largely off the radar.

The tobacco industry has the government’s ear because they’re arguably one and the same. The Finance Ministry owns 67% of Japan Tobacco, or JT, which until 1985 was a government monopoly. In an era of tight budgets, tobacco contributes $19 billion a year to government coffers in taxes and dividends, making it among the largest revenue sources. The ministry, not health authorities, controls tobacco policy, and promotion of the industry is an explicit national goal.

Add it up and, critics charge, you have a huge conflict of interest at best, with Japanese like Araki the big losers.

Close ties between the state and tobacco interests exist in many countries, but few affluent nations can touch Japan. Increasingly, tobacco policy in the world’s second-largest economy is out of step even with Third World countries.

“Japan is 30 years behind Europe and the U.S.,” said Yoshio Isayama, president of the Lawyers Organization for Nonsmokers’ Rights, representing Araki. “Why hasn’t Japan learned from their experience? Citizens just aren’t given the facts.”

Warning labels on U.S. cigarette packs include: “Smoking Causes Lung Cancer, Heart Disease, Emphysema, and May Complicate Pregnancy.” In Australia, one label screams: “Smoking Kills!” And in Canada there is: “Smoking Makes You Impotent” beside a picture of a drooping cigarette ash.

With the tobacco industry in the driver’s seat here, however, Japan’s warning label is among the world’s weakest: “Please remember to follow good smoking manners. As smoking might injure your health, please be careful not to overdo it.”

“People from overseas laugh when they hear these,” said Bungaku Watanabe, director of the Tobacco Problems Information Center, a civic group. “They’re not warnings. They’re a joke.”

The Finance Ministry, in response to written questions, said it believes Japanese are adequately informed about tobacco-related health issues, with smoking an individual decision. There should be no requirement that Japan ban or reduce consumption, it added, given that tobacco is a legal product.

JT has argued in and out of court that the health risks are not scientifically proved. Atsuro Ito, a JT spokesman, said warning labels and health policy are determined by the government. The company, Japan’s only domestic producer, is intent on finding new tobacco products with greater appeal for consumers, including women, he added. “We leave it to their judgment whether to buy them or not.”

Although JT produces Marlboro cigarettes for the Japanese market under license from Philip Morris Cos., which has admitted that its cigarettes cause cancer, JT continues to deny any causal link. Yet the Japanese company, which has diversified into pharmaceuticals and food, also has invested millions researching drugs to combat lung cancer.

Meanwhile, JT gave away 1.2 million cigarettes to 5,000 nursing homes last year during the annual Respect for the Aged holiday, and each year it distributes thousands of special crest-emblazoned smokes to volunteers who help maintain the Imperial Palace in Tokyo.

Only in 1998 did Japan ban tobacco television ads -- 27 years after they were pulled in the United States and 33 years after Britain. The “ban,” however, is voluntary and includes loopholes. There are no restrictions on programming: Since 1998, the number of characters lighting up in TV dramas has nearly doubled, according to the Tobacco Problems Information Center.

JT also sponsors hundreds of “manner ads” a week. The 10-second television spots advise viewers not to fling their butts or otherwise disturb nonsmokers.

“The message is, it’s all right to smoke as long as you don’t litter,” said Watanabe, the center director. “It’s also a type of insurance. By sponsoring these ads, they’re pretty sure the networks won’t do any negative programs on tobacco health issues.”

JT counters that the ads help ensure equal rights for smokers and nonsmokers and says cigarette giveaways are done at the behest of the government. “I believe those who receive free tobacco appreciate it,” Ito said.

Then there are Japan’s ubiquitous cigarette vending machines: about 630,000 nationwide, including eight inside the Health Ministry, in a country smaller than California.

Their obvious if unstated aim, say critics, is to fuel the lucrative youth market, with its promise of lifelong loyalty. Surveys show that as many as 76% of high school smokers buy their cigarettes from machines.

“I hate it when preachy adults lecture us about cigarettes,” said Maki Tanaka, an 18-year-old high school student and a vending machine user hanging out in Tokyo’s Harajuku area. “When I get irritated, a smoke really helps calm my nerves.”

The Youth Smoking Prohibition Law includes penalties for selling tobacco to minors, but it’s rarely enforced. A single indictment has been handed down over the last decade, and no one has been punished. JT and the government resist surveys of youth smoking trends on the grounds that it’s illegal for people under 20 to smoke. JT also says vending machine restrictions are adequate.

Culture also has played a role in Japanese society’s widespread acceptance of tobacco, reflecting long-standing views toward government, personal responsibility and conformity in the interest of group harmony.

“We’re taught to trust government,” said Yumiko Mochizuki-Kobayashi, a former Health Ministry official. “And blaming others for your own actions isn’t seen as a virtue. This is the culture of hara-kiri, where you take responsibility for your own death.”

Those who speak out aggressively face criticism, even harassment. Former friends have accused plaintiff Araki of mental instability. People trying to quit report that colleagues blow smoke in their faces, drop cigarettes in their pockets and urge them repeatedly to give tobacco another try.

Even so-called reformist politicians rarely rock the boat.

“If you want to smoke, that’s fine. Just try not to bother others,” Prime Minister Junichiro Koizumi, an ex-smoker, said during last year’s global No Tobacco Day.

With Japan’s lucrative adult male market saturated, JT and foreign companies such as Philip Morris and RJR Nabisco are targeting the female market with alluring ads of young, healthy-looking women laughing at champagne parties as they eat birthday cake and wear tiaras. In a legacy of male chauvinism, Japanese women traditionally have not smoked in great numbers, so they offer a temptingly huge marketing opportunity.

“There are so many ads aimed at women now,” said Nobuko Nakano, head of a one-person group called Women’s Action on Smoking. “They now have equal rights to die.”

JT also is pushing aggressively into the international arena. In 1999, it purchased RJR Nabisco Holding Corp.’s international operations for $7.8 billion, a move that made JT the world’s third-largest producer after Philip Morris and British American Tobacco.

Critics, meanwhile, say tar and nicotine levels listed on cigarette packs here rely on outdated methods that understate what smokers inhale. If techniques recommended by the World Health Organization were employed for Japan’s Frontier Light brand, for instance, critics say, the tar figures on the package would be 6.7 times higher.

While more countries are sharply boosting tobacco taxes -- and the World Health Organization says a 10% price hike results in a 4% drop in consumption -- Japan has kept prices low.

Cigarettes in Japan run about $2 a pack, roughly half the average in the U.S., with taxes here having risen only 13 cents a pack since 1986. The cost is among the lowest in the industrialized world indexed to wages: A cigarette in Tokyo is worth about 8 minutes on the job for the average worker, compared with 20 minutes in Los Angeles and 40 in London.

JT argues that its methods of measuring tar comply with Japanese law and adds that cigarette buyers already shoulder enough of the overall tax burden.

“We wouldn’t want to impose any further burden on consumers,” Ito said.

The greatest source of industry clout is the Tobacco Business Law, one of a string of related measures dating to 1904. The law says the government must own at least 50% of JT in perpetuity and, as a matter of national policy, “promote the healthy development of the tobacco industry and ensure stable revenue in the interest of a sound national economy.”

“This law is the heart of evil,” said attorney Isayama. “This is the real axis of evil.”

In contrast to the Finance Ministry’s large tobacco section, the Health Ministry doesn’t have a single full-time official working on smoking issues -- even though smoking accounts for the nation’s highest level of premature deaths, triple the number of suicides and nine times that of traffic fatalities.

The national health budget this year for anti-smoking awareness is $180,000, for a practice that kills 95,000 Japanese a year. By comparison, the budget for the prevention of AIDS, which kills approximately 45 people a year, is $94 million.

“So many decision-makers in Japan smoke,” said Takafumi Hirama, director of the Hirama Hospital here in Shimotsuma, about 35 miles north of Tokyo. “Their brains have become paralyzed by the drug.”

The Health Ministry has displayed rare moments of bravery, despite having its annual budget approved by the powerful Finance Ministry. In 1997, it issued a white paper saying smoking is the direct cause of a range of health problems. Although this is pretty tame by overseas standards -- U.S. government reports with such warnings date to 1964 -- it represented Japan’s first such official acknowledgment. Parallel efforts to list secondhand smoke as a risk were squelched by pro-tobacco forces.

In 1999, mavericks within the Health Ministry challenged the nation to halve its smoking rate by 2010. The furor from bureaucrats, politicians and the nation’s 12,000 tobacco farmers and 306,000 retailers -- known collectively as the Tobacco Tribe -- was so great that the goal was scrapped.

“I sacrificed my career,” said Mochizuki-Kobayashi, the former Health Ministry official who was involved in that fight and was later relegated to a ministry-affiliated research institute. “Still, it was worth it. Some future lawsuit or journalist may be able to learn from our failure.”

More often, battles are decided far from the public eye. The Tobacco Business Deliberation Council, a key committee that advises on policy, is packed with pro-tobacco members; there isn’t a single consumer or anti-smoking group represented.

“Japan’s policy is not only a mistake, it’s criminal,” said attorney Isayama. “Smokers are totally deceived by the government into thinking it’s just an ordinary product and a matter of individual choice rather than an addiction.”

Tokuaki Shobayashi, assistant director with the Lifestyle Diseases Control section, disputes the view that tax revenue is the government’s main concern, “although it’s of course a factor.” Tobacco health policy here may lag other countries’ because it takes time to collect scientific information, he said, adding that he’s confident usage will decline and social attitudes change over time.

Nonprofit organizations, which serve as pressure groups in other societies, have little impact here, given restrictive tax policies and a weak tradition of social activism. Compared with the American Cancer Society, the American Lung Assn. and others in the U.S., Japan’s 23 most active anti-smoking civic groups rely almost exclusively on volunteers. Their combined budget is $16,000 a year.

Despite so many smokers and so little pressure to quit, Japan has a per capita rate of lung cancer lower than that of the United States, where about 23% of adults smoke. The disease claims 55,000 lives a year here, or 1 out of every 2,300 Japanese; the U.S. toll of 157,000 is roughly 1 out of 1,750 Americans.

Nonetheless, lung cancer overtook stomach cancer in the 1990s to become Japan’s leading cancer killer. And the numbers keep rising.

A few scientists over the years have issued clarion calls against the industry and voiced frustration at Japan’s reluctance to accept overseas studies, as if Japanese were physiologically different. A JT-funded institute fills scientific journals with papers suggesting that cancer is caused by anything but tobacco, clouding any nascent debate.

“There’s collusion between JT and so-called scientific experts,” said lawyer Isayama. “We call them lap dogs.”

So far, the courts in Japan have balked at upending the tobacco status quo, although Araki and his fellow plaintiffs hope to change that. Their lawsuit seeks $80,000 in damages for each, a ban on vending machine sales, tougher warning labels and an end to what they see as deliberate misinformation practices by JT and the government.

Araki, a former dentist living in a nursing home in Shimotsuma, remains hopeful that Japan will reverse what he sees as a deeply flawed policy. Araki saw his addicted father stoop to smoking dried grass during the war years.

He says he started smoking when JT, then fully government-owned, handed out free tobacco after World War II, when the country was devastated and food was scarce. The implicit message was clear, he says: Smoking is good for patriotism, for nation-building, for morale.

Araki’s 50-cigarette-a-day habit caught up with him in 1981 when he climbed the stairs to his fourth-floor office and couldn’t stop coughing. A hospital visit revealed the tumor. He scheduled an immediate operation and gathered his terrified family around him to deliver a message: I’m not going to die.

Doctors gave him a year. Drawing on the inspiration of his samurai grandfather, he fought his fate by moving from Tokyo to a tiny island with clean air. Gasping for breath, he contracted with an oxygen company against the advice of doctors, long before that was accepted therapy in Japan.

“This has become my best friend,” he said, patting one of the green cylinders to which he’s attached 20 hours a day through breathing tubes. “It’s kept me alive.”

Even if he and his fellow plaintiffs win their suit, Araki said, the settlement will cover only their expenses. Still, he said, he hopes to teach JT and the Finance Ministry a lesson.

“I’d really like to give them a piece of my mind,” he said. “It’s my way of getting back at JT and the government for all they’ve done to me.”

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(BEGIN TEXT OF INFOBOX)

Male smokers

The percentage of Japanese men who smoke is low compared with some other Asian nations but high relative to Western nations with similar standards of living.

Percent of men who smoke:

Philippines -- 75%

Kenya -- 67

S. Korea -- 65

China -- 63

Russia -- 63

Tunisia -- 61

Mexico -- 51

Turkey -- 51

Japan -- 49

India -- 45

Romania -- 43

Australia -- 27

United States -- 26

Sources: World Health Organization, American Cancer Society

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Rie Sasaki in The Times’ Tokyo Bureau contributed to this report.