Japan’s Indoor Smoke-Free Laws Show Modest Gains, Exemptions Remain a Concern

Tsukuba, Japan—Recent research indicates that Japan’s efforts to reduce secondhand smoke exposure through the Revised Health Promotion Law and local ordinances have resulted in a modest increase in smoke-free establishments, though significant challenges remain due to existing exemptions.

National Law and Local Ordinances Impact Smoke-Free Environments

In April 2020, Japan fully enforced the Revised Health Promotion Law, introducing a nationwide ban on indoor smoking in restaurants and similar hospitality venues.¹ However, the law allows temporary exemptions for pre-existing slight-scale restaurants and bars, permitting indoor smoking if individuals under the age of 20 are not exposed.¹

To address the potential public health impact of these exemptions, the Tokyo Metropolitan Government and Chiba City implemented stricter passive smoking prevention ordinances. A multi-institutional research team assessed the effects of both the national legislation and local ordinances using data from a major online restaurant review platform covering the period 2016-2022.⁴

Proportion of Smoke-Free Establishments Increased

The research team estimated that the proportion of smoke-free establishments nationwide increased by 5.7% points immediately after the enforcement of the Revised Health Promotion Law.⁴ In areas governed by the Tokyo Metropolitan Government and Chiba City, where additional ordinances were in place, the proportion of smoke-free establishments increased by 13.5%, with 7.8% points specifically attributable to the local ordinances.⁴

As of December 2022, the estimated proportions of smoke-free establishments were as follows:⁴

• Restaurants: 68.3%
• Cafés: 70.2%
• Izakaya (Japanese-style pubs): 32.8%
• Bars: 25.0%

Effectiveness Limited by Exemptions

Whereas the implementation of the national law and local ordinances was associated with an increase in smoke-free establishments, a substantial number continue to allow indoor smoking due to the exemptions within the current legislation.⁴

Further research evaluating the effectiveness of the HPA found that the implementation significantly reduced observed indoor smoking in bars/pubs (82.2% pre-implementation to 55.5% post-implementation), but not in restaurants/cafés or workplaces.³ The study also noted an increase in observed heated tobacco product (HTP) use in smoke-free places post-implementation.³

Future Directions

Researchers emphasize the importance of eliminating existing exemptions and strengthening the enforcement of current smoke-free regulations to further reduce exposure to secondhand smoke in Japan.⁴ Comprehensive regulations with no exemptions are needed to maximize public health benefits.²