Hirayama, Takeshi, M.D., M.P.H.
(Inst. of Preventive Oncology, Japan) Produced a major study that linked secondhand smoke to an increased risk of lung cancerBiographical Information:
Born in 1926, Takeshi Thomas Hirayama received M.D. and M.P.H. degrees and spent most of his professional career as director of the Institute of Preventive Oncology at Japan’s National Cancer Institute in Tokyo. By the 1950s, he had begun researching lung cancer and cigarette smoking and in 1955 he collaborated with Y. Hamano on one of the earliest Japanese studies of the subject. He subsequently worked with Ernst Wynder on several studies that investigated whether various differences in smoking habits in Japan and the United States could be linked to the country’s different lung cancer rates.
His research made him a strong advocate of tobacco control, not an easy thing in a country where tobacco is sold by a government-run monopoly. In 1971, the Japanese government refused to follow the lead of other countries by putting warnings on cigarette packets. Hirayama became an outspoken critic of the government’s position, calling it “a national humiliation … I feel it will isolate Japan from world opinion on this subject. The tobacco monopoly is a kind of sanctuary – the Government does not allow anyone from the outside to interfere with it. After all, the monopoly is a source of revenue for the national treasury.”
By that time, Hirayama had commenced a fourteen-year (1966-1979) study of 91,540 nonsmoking wives that would become his best-known work. The results were published in the British Medical Journal in 1981 under the title, “Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan.” The study concluded that nonsmoking wives of heavy smokers were more likely to develop lung cancer, and that a dose-response relationship existed. It remains one of the strongest pieces of evidence linking passive smoking to lung cancer.
The tobacco industry has gone to great lengths to try to discredit it, arguing that its methodology was flawed. The British Medical Journal subsequently published a critique of the study by industry-sponsored epidemiologist Nathan Mandel, as well as several defenses of the findings. Tobacco control advocates, however, continue to cite Hirayama’s research as a landmark. In 2000, the article was reprinted in the “Public Health Classics” section of the Bulletin of the World Health Organization, along with an appreciative commentary by Elisa Ong and Stanton A. Glantz, who wrote that, “despite the tobacco industry’s best efforts, his conclusion that passive smoking causes lung cancer has stood the test of time.”
Despite his growing international reputation, Hirayama remained a controversial figure in Japan because of his frank comments about the government’s policies on smoking. Long after other governments had mandated warnings, the Japanese government continued to allow cigarette advertising on television, finance almost no research on smoking and health, and even to make claims that smoking had health benefits. “The big difference between Japan and the United States,” Hirayama charged in 1993, “is the [state-owned] tobacco industry in Japan. It is a gorilla.” He maintained that the government’s policy was not merely irresponsible but also bad business, since he predicted that health care costs to the government would soon dwarf the revenues from cigarette sales.
Dr. Hirayama was also known for his large-scale studies of how other lifestyle factors affect cancer and was one of the earliest scientists to suggest that dietary soy offers protective effects against cancer. He died on October 26, 1995.
Sources:
Lawrence K. Altman, “Cancer Study Reports Higher Risk for Wives Of Smoking Husbands; Cancer Study Reports Higher Risk for Wives of Smoking Husbands Lung Cancer Incidence Rising,” New York Times, January 16, 1981, p. A1.
Allan M. Brandt, The Cigarette Century: The Rise, Fall and Deadly Persistence of the Product that Defined America (New York: Basic Books, 2007).
Elisa Ong and Stanton A. Glantz, “Hirayama’s work has stood the test of time,” Bulletin of the World Health Organization 78:77, 938-939; online at
http://whqlibdoc.who.int/bulletin/2000/Number%207/78(7)classics.pdf.
Richard Kluger, Ashes to Ashes: America’s Hundred-Year Cigarette War and the Unabashed Triumph of Philip Morris (New York: Vintage Books, 1996).
Takashi Oka, “Recommendation That Japanese Government Monopoly Need Not Print Cigarette Warning Is Assailed,” New York Times, March 4, 1971, p. 13.
James Sterngold, “In Japan, The State Is Tobacco, So Anti-Smoking Forces Face a Mighty Foe Indeed; When Smoking Is a Patriotic Duty,” New York Times, October 17, 1993. p. F1.
For More Biographical Information:
Who’s Who in Medicine and Healthcare(R) (Marquis(TM)). Third edition, 2000-2001. New Providence, NJ: Marquis Who’s Who, 2000. (WhoMedH 3).
Who’s Who in Science and Engineering(R) (Marquis(TM)). Fifth edition, 2000-2001. New Providence, NJ: Marquis Who’s Who, 1999. (WhoScEn 5).
Who’s Who in the World(R) (Marquis(TM)). 16th edition, 1999. New Providence, NJ: Marquis Who’s Who, 1999. (WhoWor 16).
Who’s Who in the World(R) (Marquis(TM)). 17th edition, 2000. New Providence, NJ: Marquis Who’s Who, 1999. (WhoWor 17).
Who’s Who in the World(R) (Marquis(TM)). 21st edition, 2004. New Providence, NJ: Marquis Who’s Who, 2003. (WhoWor 21).
Key Publications:
Hirayama T. Relationship of soybean paste soup intake to gastric cancer risk. Nutr Cancer. 1982; 3: 223–233. [PubMed].
Hirayama, T. Life-style and mortality. In: Wahrendorf J. , editor. A Large-Scale Census-Based Cohort Study in Japan. Karger, Basel; Switzerland: 1990. pp. 41–45.
Hirayama T, Hamano Y. The significance of smoking factor in the epidemiology of the cancer of the lung. Gann. 1955; 46: 418–419. (In Japanese).
Wynder EL, Bross IJ, Hirayama T. A study of the epidemiology of cancer of the breast. Cancer. 1960; 13: 559–601. [PubMed].
Wynder EL, Fujita Y, Harris RE, Hirayama T, Hiyama T. Comparative epidemiology of cancer between the United-States and Japan—A7 2nd look. Cancer. 1991; 67: 746–763. [PubMed].
Controversy over Japanese Wives Study:
Richard Kluger, Ashes to Ashes, 499-501. Kluger summarizes the impact of the study and the industry’s attempts to discredit its methodology.
Elisa Ong and Stanton A. Glantz, “Hirayama’s work has stood the test of time,” Bulletin of the World Health Organization 78:77, 938-939; online at
http://whqlibdoc.who.int/bulletin/2000/Number%207/78(7)classics.pdf . Ong and Glantz assess why the study remains a critical one twenty years after the fact. The original article is republished along with Ong and Glantz’s appreciation.
Synonyms
Hirayama, Dr. TakeshiHirayama_Takeshi_ Dr.