To the Editor: Dr Glantz and Ms Charlesworth1 reported that after smoke-free restaurant ordinances
were enacted in California, the number of tourists traveling there from Japan
increased. However, they failed to address several confounding factors, and
the question remains whether implementation of such laws may actually increase
the number of international tourists.
As shown in Figure 1,2 the percentage of smokers in Japan has been decreasing
slightly since 1995. This confounding factor may explain in part the result
of the study. In fact, smoke-free American-style coffee shops have been gaining
popularity, and their number has been increasing in Japan.
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