state of smoking in japan

This page was last edited on: July 28, 2023 at 12:03pm

smoking rate

16.7% (2019)

Tobacco smoking rate

17.8% (2018)

Cigarette & Heated Tobacco Products Use and Trends

In 2019, 16.7% (17.8 million) adult Japanese aged 20+, smoked combustible cigarettes (CCs) and Heated Tobacco Products (HTPs) combined. (See Figure 1)
This prevalence declined from 28% in 2002 by almost 40% points to 17% in 2019. (See Figure 1)
Among these, 27.1% (13.7 million) were men and 7.6% (4.1 million) were women. (See Figure 1)

(figure 1) Prevalence (%) of Smoking Tobacco products (cigs &HTP) by japanese adults (20 + age), 2003 - 2019

Source: Japan NHNS. 2007-2019

SWITCHING ATTEMpTS

The combined smoking prevalence (cigarettes and HTPs) declined from 17.8% in 2018 to 16.7% in 2019. In 2018, the prevalence for cigarettes and HTPs use was 14.1% and 5.1% respectively, which resulted in dual use prevalence as 1.73%. By applying this to 2019 data, it suggests dual use has declined and more likely smokers made full switch to HTPs. (See Figure 2)

(Figure 2) shifting prevalence rate from cigarettes to htps in japan 2018 & 2019

Source: Authors’ estimation by Japan NHNS, 2018-2019

40% of Japanese smokers switch from cigarettes to HTP products due to concern of health risks associated with second-hand smoke (SHS) by cigarettes. 26% of Japanese smokers switched to HTPs in order to reduce number of cigarettes smoked, and 26% of Japanese smokers switched in order to quit cigarettes. (See Figure 3)

(Figure 3) Reasons for Switching to Heated Tobacco Products, Global State of Smoking Poll 2019

Source: Global State of Smoking Poll 2019

QUITTING ATTEMPTS

According to the 2019 Global State of Smoking Poll, 23% of respondents planned to quit smoking and 64% of respondents made a serious attempt to quit smoking in the past. Past quit attempts were higher among dual (70%) and HTP (69%) users only, suggesting that those who were series on quitting were in a process or have already made the shift from cigarettes to HTPs (See Figure 4)

(Figure 4) Japanese Smokers Who Made Quit Attempt Before by Type of Tobacco Products, Global State of Smoking Poll 2019

Source: Global State of Smoking Poll 2019

The shift is not surprising when we examine Japanese smokers intention towards quitting smoking. The rate of quit intention was similar in Japan HNHS survey where 26.1% Japanese smokers (20+age) wanted to quit smoking. However majority of smokers- 60% – wanted to reduce the number of cigarettes smoked or did not want to quit at all combined. (See Figure 5)

(Figure 5) quitting intentions by adult japanese smokers (2019)

Source: Japan NHNS 2019 (Table 86)

Clearly, low desire to quit smoking also explains why about half (51.3%) of smokers were not sure whether there was a cessation facility nearby. (See Figure 6)

(Figure 6) Aware of existing medical institutions that smokers can receive smoking cessation treatment in the immediate vicinity (2019)

Source: Japan NHNS, 2019 (Table 88)

MISPERCEPTION ABOUT HEATED TOBACCO PRODUCTS

According to the 2019 Global State of Smoking Poll, Japanese smokers are well-informed about the health risks associated with HTP products. (See Figure 7)
- 58.3% thinks HTPs are less to no harmful to health as compared with cigarettes
  - 70% HTP and 49% non HTP users
- Only 7% thinks HTPs are harmful or more harmful to health
  - 9% HTP and 4% non-HTP users

(Figure 7) Compared to cigarettes, how harmful Heated Tobacco Products to health, Global State of Smoking Poll 2019

Source: Global State of Tobacco Poll 2019

REGULATIONS FOR TOBACCO PRODUCTS & HEATED TOBACCO PRODUCTS

Japan ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2004.
WHO’s demand reduction measures embodied in the MPOWER framework were evaluated as ‘complete’ for monitoring and mass media in 2021. Other measures such as cessation programs and health warnings were evaluated to be ‘moderate’ while advertising was found to be either ‘weak or no policy’ in this area. Measures for smoke-free environments were ‘minimal’.
HTPs are regulated similar to cigarettes in Japan — flavored products are not restricted and there is no plain packaging. Although there are no pictorial health warnings on tobacco and HTP products, textual health warnings must cover at least 30% of the front and 30% of the back of packages as of 2003.
Tobacco products’ sale are prohibited for those younger than 20 years of age.
It is worth noting that changes are taking place on excise tax policies. There are four types of taxes levied on cigarettes and HTPs in Japan: national tobacco taxes, local (prefectural and municipal) tobacco taxes, a national special tobacco surtax and a sales (consumption) tax. In 2019, cigarettes had the highest excise tax rate (52.6%) among other excisable goods in Japan.
E-cigarettes containing nicotine are allowed in Japan by prescription only.

HEALTH AND ECONOMIC BURDEN FROM TOBACCO USE

Since 2011, tobacco attributable deaths have been declining 194 thousand in 2011 to 187 thousand in 2019.
In 1990, tobacco was responsible for 38% of all NCD deaths but that fell to 32% in 2019.
In 2019, tobacco was responsible for an estimated 211,756 deaths (one out of three deaths in Japan).
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).

MARKET AND CONSUMPTION

CIGARETTES:

In 2020, 99 billion combustible cigarette sticks sold for total market value of ¥2,474 billion (US$23.2 billion) in Japan.
Japan achieved 69% reduction on cigarette demand from 130 packs per capita in 1990 to 40 packs per capita in 2020 (see Figure 8).

(Figure 8) Tobacco Deaths, share in NCDs and Cigarette Consumption in Japan

Source: GBD 2019, Tobacco Institute of Japan , e-Stat Japan

HEATED TOBACCO PRODUCTS (HTPs):

In 2014, HTPs entered to Japanese tobacco market.
In 2015, 547 million sticks of HTP sold In Japan (91% of global market) with a US$147 million market value.
In 2020, 9 billion sticks of HTPs sold (34% of global volume), with a ¥1.1 trillion (US$10 billion) market value.
First three quarters of 2021 34.5 billion sticks of HTPs sold with ¥925.5 billion market value.
In 2022, it is estimated that HTPs will surpass cigarettes with 51% share in total cigarettes & HTP combined volume in Japan.

EXCISE TAX

There are four types of tax levied on cigarettes and HTPs in Japan, including national tobacco tax, local (prefectural and municipal) tobacco tax, national special tobacco surtax and the sale (consumption) tax.
In 2021, total excise tax for HTP per pack was ¥131.03, while for cigarettes it was ¥284.9, with HTP excise 54% lower than that of cigarettes. Excise liability for HTPs was 24.3% of retail price as compared with cigarettes at 52.8% in 2021. (See Figure 9)

(Figure 9) Retail Price and Excise Tax Per pack for Heated Tobacco Products and Cigarettes

Source: JTI Fact Sheets 2020

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