Street smoking bans in Japan: A hope for smoke-free cities?

Objectives This study analysed 112 municipalities enforcing municipal smoking restrictions on streets in Japan to examine anti-smoking measures implemented in urban settings from a health perspective and derive lessons for future tobacco control.Methods Municipal governments implementing ordinances which restrict smoking on streets were identified through grey literature review. Implementation period, characteristics, scope, and department responsible were examined.Results Since the first municipal regulation was introduced in 1997, many other municipalities have followed. Enforcement of fines started in 2002, which is now a common practice nationwide. Nevertheless, the health impact of exposure to secondhand smoke is not clearly articulated in the ordinances. Street smoking bans have been developed in connection with "beautification" and littering prevention for environmental purposes, and local health departments do not have responsibility for these ordinances.Conclusions There is potential to further prevent secondhand smoke exposure if such measures are expanded to indoor environments and integrated into broader policies. For policy-makers and advocates, the Japanese experience provides information on an additional tobacco control intervention as well as clues in the process of design, implementation and enforcement of such municipal measures. A more comprehensive and health-driven approach is required to effectively address the harm of secondhand smoke in Japan.