Tobacco is one of the major preventable causes of death and disability. This is widely known in both Japan and the USA, and although the smoking rate in the USA is decreasing, that in Japan remains high. The tobacco histories of these two countries, which provide the background to this difference, are herein compared. The antismoking movement is becoming more vociferous in both countries. Publicity regarding of the dangers of smoking, warning signs on tobacco packages, the introduction of antismoking devices, a ban on commercials for tobacco-related products on TV and the radio, no-smoking seats on airplanes, and litigation against the tobacco industry have all been introduced. However, major differences remain between these two countries. The tobacco industry in the USA has been a private company since it was first established. Courts have ordered the tobacco industry to pay compensation for damage to health resulting from tobacco. Smoking is strictly restricted inside buildings. Advertisements for nicotine gum and nicotine patches and reports on the dangers of smoking are regularly broadcast. In the case of Japan, the government at first nationalized the tobacco industry, and then made it a private company, although the government still holds two-thirds of its stock. Moreover, it established the Tobacco Business Law to support the company. The main purpose of antismoking campaigns in Japan is a partial ban on smoking. On the basis of these differences between the two countries regarding the history of tobacco, the antismoking movement in Japan has yet to choose which path to take.