LIFETSTYLE | Heated tobacco products drive steep drop in smoking rates in Japan, studies find
Dr. Lorenzo Mata Jr.
New research shows that heated tobacco products (HTPs) are linked to a significant decline in Japan’s cigarette consumption.
“Transformation of the Tobacco Product Market in Japan, 2011–2023,” a study published in October 2024 in the international peer-reviewed journal Tobacco Control, reported that per capita and total cigarette sales in Japan decreased by more than 50% between 2011 and 2023. This trend remained relatively flat until 2015, when HTPs were introduced to the Japanese market. The rate of decline accelerated markedly afterward.
“Halving the cigarette market in Japan in just over a decade is a remarkable achievement, and figuring out how to replicate this type of change elsewhere should be a priority for public health research,” the study concluded.
Another study estimated that if half of the smokers in Japan shifted from combustible tobacco to HTPs, up to 12 million tobacco-related illnesses could be prevented, representing potential savings for the Japanese healthcare system of up to 454 billion yen.
Titled “Switching from Cigarettes to Heated Tobacco Products in Japan—Potential Impact on Health Outcomes and Associated Health Care Costs,” the study was published in September 2024 in the international peer-reviewed, open-access journal Healthcare (Basel).
Japan should continue to prioritize “cost-efficient measures that promote public health and economic benefits,” including encouraging smokers to switch to reduced-risk products, increasing awareness of health risks, and adopting a harm-based taxation approach, the study stated.
International health advocates called on other countries to consider emulating Japan’s adoption of harm reduction as a tobacco control measure.
Dr. Lorenzo Mata, president of the Philippine health advocacy group Quit for Good, believes that newer smoke-free alternatives such as heated tobacco and vapes offer a better way to reduce smoking prevalence.
“Education on and access to these less harmful alternatives should be prioritized if we really want to help smokers,” Mata said.
Speaking at the Global Tobacco and Nicotine Forum in 2023, Hiroya Kumamaru, vice director at Japan’s AOI Universal Hospital, noted that smoking was the top cause of death in Japan in 2019, with high blood pressure a close second—likely due to the country’s aging population.
“By 2019, almost one-third of male and one-quarter of female tobacco consumers were using HTPs, [which is] amazing,” Kumamaru said.
He addressed concerns over potential unintended consequences, such as dual use or youth uptake, by citing survey data showing low initiation or reinitiation—2 % in the first year and 1.3 % in the second. Notably, the introduction of HTPs did not lead to increased youth initiation.
In response to the ongoing burden of smoking-related diseases, Japan’s sustained pivot to reduced-risk products presents a viable framework for countries pursuing similar public health goals.
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