『保健医療科学』 2026 Vol.75 No1 p.42-51（2026年2月）
Topics：Recent topics in public health in Japan 2026
＜ Review / 総説 ＞
Limited progress in tobacco control in Japan:An assessment 20 years after the WHO FCTC
INABA Yohei, BEKKI Kanae, NISHIMOTO-KUSUNOSE Shoichi, USHIYAMA Akira
Department of Environmental Health, National Institute of Public Health
日本のたばこ対策はなぜ進展しないのか ―FCTC 発効 20 年後の停滞要因の分析―
稲葉洋平，戸次加奈江，楠瀬翔一，牛山明
国立保健医療科学院生活環境研究部
Abstract
Marking the 20th anniversary of the entry into force of the WHO Framework Convention on Tobacco Control (FCTC) in 2005, this study systematically evaluates the progress and stagnation factors of domestic tobacco control in Japan. The assessment was conducted with reference to the WHO MPOWER package and FCTC Articles 9 and 10. The analysis revealed significant disparities between different areas of Japan’s tobacco control policy. Certain institutional advancements were recognized in “demand reduction measures,” such as the strengthening of indoor passive smoking regulations through the amendment of the Health Promotion Act enforced in 2020 and the development of smoking cessation treatment systems,including insurance coverage and online medical consultations. However, Japan still falls considerably short of international best practices in adopting pictorial health warnings recommended by the WHO, implementing comprehensive legal bans on advertising and promotion, and significantly increasing taxes with public health as the primary objective. Particularly notable stagnation was observed in the areas governed by Articles 9 (regulation of the content of tobacco products) and 10 (regulation of tobacco product disclosure) of the FCTC. Japan lacks comprehensive tobacco product regulations, such as those in advanced cases in the EU.Its principal law, the Tobacco Business Act, falls under the jurisdiction of the Ministry of Finance and focuses primarily on fiscal contributions and the sound development of the industry. As a result, legal regulations on the contents of tobacco products and independent verification systems for those products independent of the tobacco industry remain undeveloped. The underlying causes of this stagnation are rooted in structural factors unique to Japan’s tobacco control governance: misalignment of policy objectives due to the separation between the Ministry of Health, Labour and Welfare and the Ministry of Finance; institutional and economic ties, including capital relationships between the government and Japan Tobacco (JT); and the concentration of tobacco products information with the industry (asymmetry of information), all of which hinder the prompt incorporation of scientific public health findings into the legal regulations. The current situation regarding heated tobacco products (HTPs), where information dissemination led by manufacturers precedes the establishment of scientific evaluations in what has become one of the world’s largest markets, further exemplifies these vulnerabilities. In conclusion, to advance Japan’s tobacco control efforts, it is essential to strengthen individual measures and structurally separate industrial policy from public health policy and legally establish a decision-making process grounded in independent regulatory science.
keywords : WHO FCTC, Tobacco Control Governance, FCTC Articles 9 and 10, Heated Tobacco ProductsInstitutional Factors
＜抄録＞
本論文は，日本が 2004 年にWHOたばこ規制枠組条約（FCTC）を批准してから 20 年の節目を迎え，WHOのMPOWERパッケージおよびFCTC第 9 条・第 10 条を参照枠組みとして，国内のたばこ対策の進捗と停滞要因を体系的に評価することを目的とした
分析の結果，日本の対策は分野間で顕著な差異があることが明らかとなった ．2020 年の改正健康増進法施行による屋内受動喫煙対策の強化や，保険適用およびオンライン診療を含む禁煙治療体制の整備といった「需要削減策」においては，一定の制度的進展が認められた ．しかし，WHOが推奨する警告画像表示の採用や包括的な広告・宣伝の法的禁止，公衆衛生を主目的とした大幅な増税については，国際的なベストプラクティスと比較して依然として大きな乖離が存在する ．特に深刻な停滞が確認されたのは，FCTC第 9 条（製品成分の規制）および第 10 条（情報開示）に関わる領域である．日本にはEU等の先進事例に見られるような包括的な製品規制法制が存在せず，主要法規である「たばこ事業法」が財務省の所管下で財政寄与や産業の健全な発展を主目的としているため，成分の法的基準値や独立した検証制度が未整備のままとなっている．この停滞の背景には，日本のたばこ制度的枠組み特有の構造的要因がある ．厚生労働省と財務省の分立による政策目的の不一致，政府と日本たばこ産業（JT）との間の資本関係を含む一体的な構造，および製品情報の産業側への偏在（情報の非対称性）が，公衆衛生上の科学的知見を迅速に法規制へと反映させる際の障壁となっている．世界最大級の市場となった加熱式たばこ（HTP）への対応においても，科学的評価が確立する前にメーカー主導の情報発信が先行する現状は，こうした制度的脆弱性を象徴している．
結論として，日本のたばこ対策を今後さらに進展させるためには，個別施策の強化に加え，産業政策と公衆衛生政策の構造的な分離を図るとともに，独立した規制科学に基づく意思決定プロセスを法的に確立することが不可欠である
キーワード：たばこの規制に関する世界保健機関枠組条約，たばこ製品規制と情報開示，たばこ規制ガバナンス，加熱式たばこ，制度的要因
Limited progress in tobacco control in Japan: An assessment 20 years after the WHO FCTC