Challenges and opportunities for greater tobacco control in Japan.

Japan is a high tobacco burden country with over 20 million smokers in 2017. Tobacco control measures in Japan has been criticised as largely inadequate and ineffective despite ratifying the World Health Organization's Framework Convention on Tobacco Control in 2004. Numerous factors such as pro-tobacco legislators, regulatory oversight of the primary Japanese tobacco company from the Ministry of Finance and industry interference on the policy-making process in Japan have prevented aggressive tobacco control efforts. Given the intricate challenges in Japan, it is important to develop feasible and effective smoking cessation strategies. In this paper, we have analysed the trends in tobacco prices, sale and smoking prevalence, major tobacco/smoking policies and some of the industry-related challenges that have prevented the development of effective tobacco control measures in Japan. We have emphasised the need for stronger implementation of the World Health Organization's Framework Convention on Tobacco Control and its MPOWER policy package and to separate the tobacco industry from the tobacco control policymaking process to promote cessation and abstinence from smoking and better sensitisation against exposure to second-hand smoke.