state of smoking and health in japan

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16.2% (2022)

16.8% (2022)

In 2022, an estimated 18.6 million adults aged 15 years and older population in Japan are tobacco product users. This positions Japan as the 10^th globally and 2nd in the WHO Western Pacific Region (WPR) in terms of the number of tobacco products users.
In 2019, 26.1% of Japanese smokers aged 20 and above reported a desire to quit smoking, while 60% expressed a desire to reduce the number of cigarettes smoked or did not want to quit at all.
- More than half of those who smoke (51.2%) were not aware of a cessation facility nearby.
The demand for cigarettes reduced by 56% from 82.1 packs per capita in 2010 to 36.2 packs per capita in 2022.

In 2019, 16.7% or 17.8 million Japanese adults aged 20 and above smoked combustible cigarettes (CCs) and heated tobacco products (HTP) products. Among those who smoked, 12% were cigarette and 4.5% were HTP users.( Japan NHNS, 2018-2019)
In 2022, Japan used 52.2 billion sticks or 21 pack of 20 sticks of heated tobacco products (HTPs) per capita.

In 2019, it is estimated that tobacco was the highest risk factor that drove the most death and disability combined in Japan.
Tobacco was responsible for an estimated 211,757 deaths (one out of three deaths in Japan).
- Of tobacco deaths, 199 thousand or 94% were due to smoking and 17 thousand or 8% from secondhand smoke.
In 2019, the top 10 causes of the most deaths in Japan included Stroke ranking 2^nd, Ischemic Heart Disease (IHD) ranking 3^rd, Lung Cancer ranking 5^th, and COPD ranking 9^th.
- Tobacco was responsible for 14 thousand or 13% of all Stroke deaths, 20 thousand or 16% of all IHD deaths, 20 thousand or 74% of all COPD deaths, and 57 thousand or 85% of all Lung Cancer deaths in Japan.
In 2019, tobacco use caused an estimated loss of 4.4 million disability-adjusted life years (DALYs)- which was about one-third of total DALYs where tobacco accounts for 406 thousand DALYs for Stroke, 927 thousand DALYs for Lung Cancer, 436 thousand DALYs for COPD, and 425 thousand DALYs for IHD.
Tobacco-attributable deaths and disease have fallen since 2011, owing to reduced smoking and cigarette sales (a 69% reduction from 322 billion in 1990 to 98.8 billion in 2020).

Japan ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2004

Heated Tobacco Products HTPs and e-cigarettes, both with and without nicotine content, are available in Japan. HTPs are regulated under the tobacco regime, while e-cigarettes with nicotine are classified as pharmaceutical products. E-cigarettes without nicotine are subject to consumer safety regulations. Key points include:
- Medical licensing is required to sell and a prescription is necessary to purchase e-cigarettes with nicotine in Japan.
- Text health warnings cover at least 50% of both surfaces for HTPs. E-cigarettes without nicotine are not subject to carrying health warnings.

In 2022, the total tax rate on retail prices of a pack of cigarettes was 59.9%.
As of October 2022, Japan unified excise tax applications between HTPs and CCs. In 2023, the excise value for HTPs is 88/pack, representing 55.33% of the retail price (JPY551/pack). The excise value of CCs is also JPY304.88/pack, accounting for 50.81% of the retail selling price (JPY600/pack).

Slightly higher than the minimum coverage for smoking bans with complete compliance and minimum coverage for advertising bans with unknown compliance are enforced as of 2022.
- HTPs are prohibited in some public places including transport, state buildings, schools, hospitals, and nurseries.
- No smoking bans on public usage and minimal advertising restrictions are imposed on e-cigarettes.

Tobacco products and HTPs cannot be sold to individuals younger than 20 years of age, while there is no age restriction for e-cigarettes.

Estimated figures indicate that illicit cigarette trade has been consistently below 1% between 2008 and 2022

Japan is not a major unmanufactured tobacco producer. In 2022, the country’s unmanufactured tobacco production amounted to approximately 9.8 thousand tons, representing just 0.2% of the global production of 5.8 million tons. This indicates a substantial decrease compared to the 2010 production level of 29.3 thousand tons, reflecting a 70% reduction in Japan’s unmanufactured tobacco output in 2022.
Similarly, Japan witnessed a significant reduction in the harvested area for unmanufactured tobacco. The harvested area declined by 76%, dropping from 15 thousand hectares in 2010 to 3.6 thousand hectares in 2022 (FAOSTAT)

As research findings become available that are inclusive of additional gender identities, the Foundation will update the information presented.