How much progress has been made toward a smoke-free environment in the restaurants and bars of Japan? Limitations of partial bans and their enforcement

Abstract Background In April 2020, the revised Health Promotion Act and Tokyo Metropolitan Ordinance to prevent second-hand smoke (SHS) exposure was fully enforced. The government has provided an exemption for small-scale, existing establishments by allowing them ‘unregulated’ status, and it is uncl...

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Main Authors: Aoi Kataoka, Isao Muraki, Masakazu Nakamura, Yuri Ito
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-20765-6
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author Aoi Kataoka
Isao Muraki
Masakazu Nakamura
Yuri Ito
author_facet Aoi Kataoka
Isao Muraki
Masakazu Nakamura
Yuri Ito
author_sort Aoi Kataoka
collection DOAJ
description Abstract Background In April 2020, the revised Health Promotion Act and Tokyo Metropolitan Ordinance to prevent second-hand smoke (SHS) exposure was fully enforced. The government has provided an exemption for small-scale, existing establishments by allowing them ‘unregulated’ status, and it is unclear to what extent indoor smoking bans have been applied in these small bars and restaurants. In this study, we report on indoor smoking status before/after the enforcement of the current legislation both regulated and unregulated restaurants and bars. Methods Self-questionnaire surveys were conducted in March 2020 and 2021. We applied the questionnaire to 6,000 restaurants and bars in Tokyo, Osaka and Aomori in the first survey and to 3609 restaurants in the second survey, including those that had responded to the first survey as well as 2800 additional establishments. We calculated the proportions of indoor smoking status before/after enforcement both regulated and unregulated establishments. In addition, we calculated the national estimate of indoor smoking status in all restaurants and bars in Japan after the enforcement using a restaurant guide website and the results of this study. Results The responded establishments were 879 to the first (response rate: 14.7%) and 837 to the second (response rate: 23.2%). Of all the establishments, 67.0% kept “separate smoking or smoking” status, and 62.1% of unregulated establishments kept “separate smoking or smoking”. Although all the regulated establishments were required to change to “no smoking” by law, 78.4% that were “separate smoking or smoking” before the enforcement did not change their indoor smoking status. The national estimate of smoking status showed that the proportion of “no smoking” would change from 54.5% to 69.4% after the enforcement. If all regulated establishments changed smoking status to “no smoking”, the ideal proportion of “no smoking” would be 85.8% in Japan. Conclusions More unregulated restaurants and bars changed to “no smoking” than planned before the enforcement. In contrast, most of the regulated restaurants and bars continued to be “separate smoking or smoking” in non-compliance with the legislation. In order to prevent SHS exposure in all restaurants and bars, we need comprehensive legislation for indoor smoking bans in Japan.
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spelling doaj-art-4a389db2bd1645bbbdc7e7a9b18062522025-08-20T03:48:06ZengBMCBMC Public Health1471-24582024-11-0124111310.1186/s12889-024-20765-6How much progress has been made toward a smoke-free environment in the restaurants and bars of Japan? Limitations of partial bans and their enforcementAoi Kataoka0Isao Muraki1Masakazu Nakamura2Yuri Ito3Department of Medical Statistics, Osaka Medical and Pharmaceutical University, Research & Development CenterDepartment of Public Health, Osaka University Graduate School of MedicineInstitute of Community Medicine, Japan Association for Development of Community Medicine, Yakushimaecho 70Department of Medical Statistics, Osaka Medical and Pharmaceutical University, Research & Development CenterAbstract Background In April 2020, the revised Health Promotion Act and Tokyo Metropolitan Ordinance to prevent second-hand smoke (SHS) exposure was fully enforced. The government has provided an exemption for small-scale, existing establishments by allowing them ‘unregulated’ status, and it is unclear to what extent indoor smoking bans have been applied in these small bars and restaurants. In this study, we report on indoor smoking status before/after the enforcement of the current legislation both regulated and unregulated restaurants and bars. Methods Self-questionnaire surveys were conducted in March 2020 and 2021. We applied the questionnaire to 6,000 restaurants and bars in Tokyo, Osaka and Aomori in the first survey and to 3609 restaurants in the second survey, including those that had responded to the first survey as well as 2800 additional establishments. We calculated the proportions of indoor smoking status before/after enforcement both regulated and unregulated establishments. In addition, we calculated the national estimate of indoor smoking status in all restaurants and bars in Japan after the enforcement using a restaurant guide website and the results of this study. Results The responded establishments were 879 to the first (response rate: 14.7%) and 837 to the second (response rate: 23.2%). Of all the establishments, 67.0% kept “separate smoking or smoking” status, and 62.1% of unregulated establishments kept “separate smoking or smoking”. Although all the regulated establishments were required to change to “no smoking” by law, 78.4% that were “separate smoking or smoking” before the enforcement did not change their indoor smoking status. The national estimate of smoking status showed that the proportion of “no smoking” would change from 54.5% to 69.4% after the enforcement. If all regulated establishments changed smoking status to “no smoking”, the ideal proportion of “no smoking” would be 85.8% in Japan. Conclusions More unregulated restaurants and bars changed to “no smoking” than planned before the enforcement. In contrast, most of the regulated restaurants and bars continued to be “separate smoking or smoking” in non-compliance with the legislation. In order to prevent SHS exposure in all restaurants and bars, we need comprehensive legislation for indoor smoking bans in Japan.https://doi.org/10.1186/s12889-024-20765-6Second hand smokingPassive smokingSmoke-free legislationRestaurantsSmoking CessationSmoking Prevention
spellingShingle Aoi Kataoka
Isao Muraki
Masakazu Nakamura
Yuri Ito
How much progress has been made toward a smoke-free environment in the restaurants and bars of Japan? Limitations of partial bans and their enforcement
BMC Public Health
Second hand smoking
Passive smoking
Smoke-free legislation
Restaurants
Smoking Cessation
Smoking Prevention
title How much progress has been made toward a smoke-free environment in the restaurants and bars of Japan? Limitations of partial bans and their enforcement
title_full How much progress has been made toward a smoke-free environment in the restaurants and bars of Japan? Limitations of partial bans and their enforcement
title_fullStr How much progress has been made toward a smoke-free environment in the restaurants and bars of Japan? Limitations of partial bans and their enforcement
title_full_unstemmed How much progress has been made toward a smoke-free environment in the restaurants and bars of Japan? Limitations of partial bans and their enforcement
title_short How much progress has been made toward a smoke-free environment in the restaurants and bars of Japan? Limitations of partial bans and their enforcement
title_sort how much progress has been made toward a smoke free environment in the restaurants and bars of japan limitations of partial bans and their enforcement
topic Second hand smoking
Passive smoking
Smoke-free legislation
Restaurants
Smoking Cessation
Smoking Prevention
url https://doi.org/10.1186/s12889-024-20765-6
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