There's more to this than meets the eye. Japan had it easy for many, many years as they were able to fund their public debt internally. The pension funds are coerced into buying Japan's equivalent of Treasury Bills by the Ministry of Finance. In this way, they were able to pay govt debt and fund many large public projects as well as provide cheap credit to industry.    The current economic crisis coupled with the Japanese baby boomers starting to retire en masse has put this cozy relationship to an end as the pension funds simply don't have the cash to buy up govt debt any longer.    Japanese have the highest longevity rates in the world, but this is despite many being bedridden or sick for years until their inevitable demise. Japanese people (especially the elderly) are some of the worst hypochondriacs I have ever seen and completely clog up the hospital system over seemingly minor things.    The point is that the govt can not afford to pay for medical care like it used to. They've already started making seniors pay more deductible for hospital visits and ambulance rides (because it is so widely abused) and leaning on smokers is the next logical step as they do in fact put a lot of unnecessary pressure on the health cre system.