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Smoking brings another danger to children in Japan
  1. S Nakahara
  1. Department of International Community Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;

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    The other day, I was walking in a crowded street near a subway station in Tokyo with my 7 year old son. He was so curious that he frequently stopped to look at something before running to catch up me. Predictably, he ran into a man who was walking and holding a lit cigarette which fell after their collision. I feared that the lit cigarette might hit my son in his face or eye. However, he did not sustain any injury because the cigarette only touched his hair.

    In-street smoking while walking is becoming prevalent as most public places, including stations, workplaces, and schools, have become non-smoking zones. Smokers, prohibited from smoking in trains and stations, light cigarettes once they get to the street.1 They are usually holding cigarettes at their chest or waist levels, equivalent to the face level of children or people in wheelchairs.

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    Lit cigarettes may cause facial or eye injuries and could cause blindness to toddlers.2 Children can dart towards smokers while the smoker’s attention is diverted from the cigarette. Not only do cigarettes cause chronic diseases but they also result in burns or as foreign bodies in natural orifices, especially among children. Tobacco products are the number one cause of poisoning among children under 5 years old in Japan, accounting for about 20%.3

    In addition, lit cigarettes are also the leading cause of residential fire deaths in Japan, accounting for 19%.4 Fires not only damage people but also destroy houses, workplaces, and natural environments, resulting in a global burden physically, emotionally, and economically.5

    More importantly, the threat of these injuries undermines our feeling of safety, even though their occurrence may be uncommon. Parents with children or people in wheelchairs are fearful of being injured in the streets and this may deter them from going out. As WHO notes, reducing injuries or violence is not enough—subjective safety is also needed.6

    Child outdoor or home environments are still not safe. Recently, several municipalities in Japan enacted a bylaw that bans smoking in crowded streets. The first was in the Chiyoda ward, a business center of Tokyo. To protect people from passive smoke, the Health Promotion Law was enacted in May 2003 but only covers indoor spaces. We need to persuade policymakers to expand such legislation. We also need to continue efforts to stop smoking in homes where children live.