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Background: To enhance tobacco control in Japan, the government set a future smoking rate target (smoking prevalence = 12% by 2022) arguing that the “smoking rate target is expected if only smokers who want to quit smoking now, actually quit”. However, ideally both those wanting to quit now and those who wanted to in the past will succeed in the future. We aimed to re-define smokers who intend to quit and estimate their number. We also examined determinants of intention to quit, including daily tobacco consumption and tobacco use categories (exclusive combustible cigarette users, exclusive heated tobacco product (HTP) users, and dual (combustible cigarette and HTP)) users. Methods: Using data from the 2021 Japan ‘Society and New Tobacco’ Internet Survey, we analyzed 5,072 current smokers (had used combustible cigarettes or HTPs in the past 30 days) aged 20–80 years. Smokers who intend to quit were defined as total smokers who want to quit now, have previously attempted or previously wanted to quit. Log-Poisson regression models were used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (95%CI) for intention to quit (current or current/past), adjusting for potential covariates such as tobacco use categories. Results: Among current smokers, 40.6% want to quit now, 27.0% have previously attempted and 9.0% have previously wanted to quit. Smokers of over 20 tobacco sticks/day are less likely to want to quit now than 1–10 /day (aOR = 0.79, 95%CI = 0.71–0.87) and less likely to intend to quit (both current and past) (aOR = 0.93, 95%CI = 0.88–0.98). Exclusive HTP and dual users were more likely to intend to quit (both current and past) than exclusive combustible cigarette users (aOR = 1.09, 95%CI = 1.04–1.14) and (aOR = 1.07, 95%CI = 1.03–1.12). Conclusions: In total, 76.6% of current smokers, were defined as having intention to quit (both current and past). Applying this percentage to the target calculation, Japan’s smoking rate target would be 3.9%, considerably lower than the current target of 12%. The Japanese government may have to revise the smoking rate target. Additionally, we found that the usage of HTPs reduces intention to quit smoking. These insights have implications for setting of smoking rate targets and regulating HTPs in different countries.

Background: Heated tobacco product (HTP) use continues in Japan as the second most common product after cigarettes. While the health effects of HTPs and their secondhand emissions are not well-studied, the tobacco industry has actively marketed HTPs as a smokeless, health-conscious alternative to cigarettes to encourage home consumption. We investigated the prevalence of current tobacco product use and usage at home. Methods: The present study conducted a cross-sectional analysis of data from the 2023 wave of a nationwide, Internet-based, self-reported survey. 29,354 individuals aged 16–74 were included in the analysis. We assessed the prevalence of current (past-30-day) use for HTPs, cigarettes, non-cigarette combustible tobacco, and dual (combustible plus HTP) use. The frequency of use (daily or more than monthly) in the home was calculated for both HTPs and combustible tobacco. Multivariable Poisson regression models were employed to identify factors associated with home usage. Adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were computed. All analyses were weighted to address the Internet-based sample's selectivity and yield nationally representative estimates. Results: In 2023, the prevalence of current use was 12.4% (HTPs), 18.9% (cigarettes), 3.6% (non-cigarette combustible tobacco), and 7.4% (dual use). Among current users of any tobacco (N = 5,818), 49.8% reported daily tobacco usage within their homes, and 67.1% reported monthly or more frequent home usage. Compared to exclusive combustible tobacco smokers, exclusive HTP users exhibited higher prevalence of daily home usage (APR = 1.54; 95% CI = 1.43–1.67), as did dual users (APR = 1.10; 95% CI = 1.01–1.20). Daily home usage prevalence was notably higher for those without complete tobacco-free rules at home or workplaces, older individuals, and those with lower education levels. Those living with adult or child household member and current drinkers showed significantly lower daily home usage prevalence. Conclusion: Home usage was more common among HTP users than among combustible tobacco smokers. Ongoing efforts to assess and address the impact of indoor tobacco product use, including HTPs, on health are warranted. Regulatory and educational strategies should be considered to discourage tobacco consumption in both public and private spaces.

Background: Heated tobacco product (HTP) use has increased substantially between 2016 and 2017 in Japan. This study aims to clarify how HTP use (IQOS, Ploom, and glo) spread across the different combustible cigarette smoking statuses during 2015–16 and 2017–18 in Japan. Methods: We compared the two periods of (i) 2015 to 2016 (N = 5,366) and (ii) 2017 to 2018 (N = 3,422) from a longitudinal study randomly sampling members from the Japan “Society and New Tobacco” Internet Survey (JASTIS). Multivariable logistic regression models for current HTP use in the previous 30 days by combustible cigarette smoking status in the previous year were used adjusting for socio-demographic factors. Results: HTP use increased by 10 times in the 2017–18 cohort compared with the 2015–16 cohort according to the adjusted odds ratio (95% confidence interval) for current HTP use as 10.2 (7.03–14.8). According to smoking status, significantly higher adjusted ORs (95% CIs) of current HTP use for the after period were observed: 2.60 (1.37–4.94) for never smokers, 7.82 (3.64–16.8) for former smokers, 21.1 (5.73–77.9) for current smokers with intention to quit, and 17.0 (9.58–30.3) for current smokers without intention to quit. Conclusion: During 2015 to 2018 in Japan, HTP use dramatically increased in all subgroups except for never smokers.

Background: Heated tobacco product (HTP) use continues in Japan as the second most common product after cigarettes. While the health effects of HTPs and their secondhand emissions are not well-studied, the tobacco industry has actively marketed HTPs as a smokeless, health-conscious alternative to cigarettes to encourage home consumption. We investigated the prevalence of current tobacco product use and usage at home., Methods: The present study conducted a cross-sectional analysis of data from the 2023 wave of a nationwide, Internet-based, self-reported survey. 29,354 individuals aged 16-74 were included in the analysis. We assessed the prevalence of current (past-30-day) use for HTPs, cigarettes, non-cigarette combustible tobacco, and dual (combustible plus HTP) use. The frequency of use (daily or more than monthly) in the home was calculated for both HTPs and combustible tobacco. Multivariable Poisson regression models were employed to identify factors associated with home usage. Adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were computed. All analyses were weighted to address the Internet-based sample's selectivity and yield nationally representative estimates., Results: In 2023, the prevalence of current use was 12.4% (HTPs), 18.9% (cigarettes), 3.6% (non-cigarette combustible tobacco), and 7.4% (dual use). Among current users of any tobacco (N = 5,818), 49.8% reported daily tobacco usage within their homes, and 67.1% reported monthly or more frequent home usage. Compared to exclusive combustible tobacco smokers, exclusive HTP users exhibited higher prevalence of daily home usage (APR = 1.54; 95% CI = 1.43-1.67), as did dual users (APR = 1.10; 95% CI = 1.01-1.20). Daily home usage prevalence was notably higher for those without complete tobacco-free rules at home or workplaces, older individuals, and those with lower education levels. Those living with adult or child household member and current drinkers showed significantly lower daily home usage prevalence., Conclusion: Home usage was more common among HTP users than among combustible tobacco smokers. Ongoing efforts to assess and address the impact of indoor tobacco product use, including HTPs, on health are warranted. Regulatory and educational strategies should be considered to discourage tobacco consumption in both public and private spaces.

Background: To enhance tobacco control in Japan, the government set a future smoking rate target (smoking prevalence = 12% by 2022) arguing that the "smoking rate target is expected if only smokers who want to quit smoking now, actually quit". However, ideally both those wanting to quit now and those who wanted to in the past will succeed in the future. We aimed to re-define smokers who intend to quit and estimate their number. We also examined determinants of intention to quit, including daily tobacco consumption and tobacco use categories (exclusive combustible cigarette users, exclusive heated tobacco product (HTP) users, and dual (combustible cigarette and HTP)) users., Methods: Using data from the 2021 Japan 'Society and New Tobacco' Internet Survey, we analyzed 5,072 current smokers (had used combustible cigarettes or HTPs in the past 30 days) aged 20-80 years. Smokers who intend to quit were defined as total smokers who want to quit now, have previously attempted or previously wanted to quit. Log-Poisson regression models were used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (95%CI) for intention to quit (current or current/past), adjusting for potential covariates such as tobacco use categories., Results: Among current smokers, 40.6% want to quit now, 27.0% have previously attempted and 9.0% have previously wanted to quit. Smokers of over 20 tobacco sticks/day are less likely to want to quit now than 1-10 /day (aOR = 0.79, 95%CI = 0.71-0.87) and less likely to intend to quit (both current and past) (aOR = 0.93, 95%CI = 0.88-0.98). Exclusive HTP and dual users were more likely to intend to quit (both current and past) than exclusive combustible cigarette users (aOR = 1.09, 95%CI = 1.04-1.14) and (aOR = 1.07, 95%CI = 1.03-1.12)., Conclusions: In total, 76.6% of current smokers, were defined as having intention to quit (both current and past). Applying this percentage to the target calculation, Japan's smoking rate target would be 3.9%, considerably lower than the current target of 12%. The Japanese government may have to revise the smoking rate target. Additionally, we found that the usage of HTPs reduces intention to quit smoking. These insights have implications for setting of smoking rate targets and regulating HTPs in different countries.

Background: Heated tobacco product (HTP) use has increased substantially between 2016 and 2017 in Japan. This study aims to clarify how HTP use (IQOS, Ploom, and glo) spread across the different combustible cigarette smoking statuses during 2015-16 and 2017-18 in Japan., Methods: We compared the two periods of (i) 2015 to 2016 (N = 5,366) and (ii) 2017 to 2018 (N = 3,422) from a longitudinal study randomly sampling members from the Japan "Society and New Tobacco" Internet Survey (JASTIS). Multivariable logistic regression models for current HTP use in the previous 30 days by combustible cigarette smoking status in the previous year were used adjusting for socio-demographic factors., Results: HTP use increased by 10 times in the 2017-18 cohort compared with the 2015-16 cohort according to the adjusted odds ratio (95% confidence interval) for current HTP use as 10.2 (7.03-14.8). According to smoking status, significantly higher adjusted ORs (95% CIs) of current HTP use for the after period were observed: 2.60 (1.37-4.94) for never smokers, 7.82 (3.64-16.8) for former smokers, 21.1 (5.73-77.9) for current smokers with intention to quit, and 17.0 (9.58-30.3) for current smokers without intention to quit., Conclusion: During 2015 to 2018 in Japan, HTP use dramatically increased in all subgroups except for never smokers.