Table 3. Comparison with the WHO “Twelve steps”.

Twelve steps	Hyogo prefecture
1. Set up a planning and implementation committee	(O) Hyogo Prefecture’s DoHW established a special committee in June 2010: Hyogo Prefecture Consultation Committee for Second-hand Smoke Prevention Measures.
2. Become an expert	(O) Hyogo established an “SHS Prevention Office” in the Department of Health Promotion to research smoke-free interventions.
3. Involve local legislative experts	(O/X) The committee did not include a person from the law field. The officers responsible for legislation attended the meetings. The legal department only checked the draft.
4. Study several potential legal scenarios	(X) Legal action by the tobacco industry was not considered.
5. Recruit political champions	(X) The Governor of Hyogo worked to promote the ordinance, but we did not find evidence of any promotion in the media record (the newspapers and magazines).
6. Invite the participation of civil society organizations	(O) A non-profit organization for children in Hyogo and the Hyogo Women’s Association were invited to the committee. The chairperson of the committee is also the chairperson of the Tobacco Control Medical-Dental Research Network.
7. Work with evaluation and monitoring experts	(O/X) The DoHW did not work with evaluation or monitoring experts, but national survey data (Comprehensive Survey of Living Conditions) are available.
8. Engage with media and communications experts	(O) The prefecture is working aggressively with the media, and the officers of the SHS Prevention Office are promoting the prevention of SHS.
9. Work closely with enforcement authorities	(O/X) The Governor has the right to order an officer to inspect a potential violation, but the prefecture did not work with enforcement authorities, such as the police or special inspectors, and did not design a clear protocol for inspections. The ordinance only established penalties and fines.
10. Develop and disseminate guidelines	(O) The prefecture announced the implementation date for legislation by means of the media, a website, and promotion materials (eg, posters, leaflets, and stickers). It also held an explanatory meeting for owners and managers of hospitality businesses. Furthermore, a contest for creating a slogan was held.
11. Celebrate the implementation day	(X) Hyogo has not celebrated the implementation day yet.
12. Ensure maintenance of the law	(O/X) The ordinance specifies that it is mandatory to maintain the ordinance for at least 5 years after it comes into force, with reviews every 3 years thereafter. However, monitoring of compliance, public opinion, indoor air quality, and workers’ health and economic impact following implementation of the ordinance is not specified.

DoHW, Department of Health and Welfare.

(o) Completely complies with the WHO’s step; (x) Does not comply with the WHO’s step; (o/x) Partially complies with the WHO’s step.