Conveying misinformation: Top-ranked Japanese books on tobacco

We examined a small number of books, which may not be representative of the population of books actually read by Japanese citizens interested in tobacco. Other search terms might retrieve a different set of books. Lists change; we do not know how often they are updated or how long these books remained listed. Nevertheless, it seems reasonable that someone not yet knowledgeable about tobacco might search using this word, and that these would be books most likely to be seen (and in the case of bestsellers, purchased) by Amazon's Japanese users.

We were unable to do a similar study examining in detail books on the Amazon site in other countries, but on Feb 18 2010, we examined the top 12 books by bestselling and relevance on the United States Amazon site, searching using the word "tobacco." Examining titles and descriptions of the books, we found only two of 24 unique listed books that appeared pro-smoking: a guide to cigars, #9 by bestselling, and the book The health benefits of tobacco, by William Campbell Douglass, #3 on the relevance list. Dr. Douglass is a well-known 'maverick' who apparently makes a living claiming to debunk so-called health and medical 'myths' (generally without offering scientific evidence for his claims) and selling books and supplements online. He also claims the Internal Revenue Service is unconstitutional and apparently has argued that paying taxes is treasonous because, he claims, there are communists in the government [12]. In any case, the U.S. site appeared to feature a far smaller proportion of books with misleading material than appeared on the Japanese version of the site. Selected quotations, while broadly representative of book content, were not randomly chosen, but were selected to illustrate misinformation conveyed. We did not have access to reader data, so we can only theorize about how reading these books might influence smoking beliefs and behaviors.

Nine pro-smoking books were reviewed. We sampled material from five of these (Table 1) to illustrate the types of misinformation conveyed. Among the other four pro-tobacco books reviewed, one was a guide to cigars, one was a pictorial history of tobacco packaging, and two were graphic cartoon books about smokers' manners, published by Japan Tobacco, Inc. [13‐16]. The latter used stylized cartoons to suggest, among other things, that smokers should buy cigarettes and portable ashtrays before going to summer festivals, or take a break by smoking after perspiring while dancing, and appeared intended to reinforce smoking as a normal part of social events, while minimizing social conflicts [15].

The 5 books excerpted were all published since 2006; all authors noted that they were smokers and books featured similar content. While suggesting that smoking cigarettes was not harmless, they put far greater emphasis on the social goods of smoking, arguing that tobacco was not harmful enough to require regulation. They emphasized Japan's long life expectancies compared to other industrialized countries despite Japan's higher smoking rates, ignoring likely contributions of the Japanese diet and other factors to this phenomenon. The books suggested that little scientific data proved that tobacco was harmful, and that other substances were worse.

The authors consistently portrayed smoking as a personal "choice" or preference, an issue of "rights" and "freedom," and said government should not get involved. If there was a tobacco problem, according to these authors, it was smokers' manners, not the product. They also linked smoking with Native American peacemaking ceremonies. Some of their assertions exactly match JT's claims [17, 18], such as blaming smokers' manners for any problems. It is unknown whether tobacco companies sponsored these publications.

Below, we provide brief descriptions of the five pro-smoking books reviewed:

This pro-smoking book by Takeda, second by relevance and 18^th among bestsellers, argued that SHS effects on nonsmokers were exaggerated. The author worked for Japan Tobacco until 1995; his argument echoes JT's SHS claims [20]. He also claimed, without citing evidence: "it is clear that elderly people in nursing homes who love to smoke live much longer" (p. 153).

Oncologist Haruhiko Natori and sociologist Masayuki Uesugi coauthored this book, 7^th by relevance and 16^th among bestselling. Among other things, it sought to convince readers that tobacco was not harmful by equating smoking with other behavior that might harm human health too, such as accidentally inhaling peanuts. Use of JT's well-known advertising phrase, "I feel great, and cigarettes taste great!" ("今日も元気だ、たばこがうまい") suggested a JT connection.

Fumiaki Matsugae, lawyer and journalist, authored this book, ninth by relevance. Matsugae admitted that tobacco is harmful, but asserted "a significant lack of scientific evidence" (p. 9) for tobacco's toxicity. Like Takeda, he questioned, "if tobacco really is as hazardous as it is said to be, how do the Japanese have the longest life expectancy even with the highest smoking rate in the world?" (p. 9).

Authored by journalist and university professor Hisashi Muroi, this was eleventh by relevance and third among bestselling; the author described smoking as "a unique gift of pleasure" (p. 70). Since people are mortal, he argued, there was no point in trying to discourage smoking: "considering that all human beings die, it is questionable to single out and harass smokers by addressing only the harm tobacco may possess" (p. 76).

Physician author Akira Hashiuchi claimed a correlation between smoking and birthrate suggests that smoking actually increases the birthrate. He also claimed smoking was socially advantageous for men, arguing that "smokers have higher social status" (p. 38). Former smokers were "men who have let go of their masculinity" (pp.118-119). Non-smoking was associated with evil because, he argued, Hitler hated smoking.