Heated Tobacco Product Smokers in Japan Identified by a Population-Based Survey

Background In this study, we aim to estimate the prevalence of heated tobacco product (HTP) smokers three years after the launch of HTPs in Japan. Methods Our study, performed in February 2018 in Japan, had a cross-sectional population-based design. A total of 4,628 adult participants (2,121 men and 2,507 women) were randomly sampled from all regions of Japan. The response rate was 57.9%. Interviews were conducted by trained investigators who visited participants' homes. A survey on current (past 30 days) and lifetime tobacco use (including e-cigarettes and HTPs), as well as numerous sociodemographic factors, was conducted. Results The age-adjusted rates (95% confidence interval) and estimated number of lifetime-HTP smokers were 14.1% (12.5-15.6%; 7.11 million men) and 3.7% (2.9-4.4%; 1.99 million women). The age-adjusted rates (95% confidence interval) for current HTP smokers were 8.3% (7.1-9.6%; 4.21 million men) and 1.9% (1.3-2.4%; 1.02 million women). Multiple variables were found to be associated with a higher prevalence of current HTP use, including being male, aged 20-39 years old, a current Internet user, a risky drinker, or a heavy episodic drinker. HTP use was also higher among men with 10 years or more of education, women with 15 years or less of education, and men with middle- or high-level household incomes. Conclusion We concluded that HTP use has increased substantially in Japan. However, regulations for HTPs are weaker than those for combustible cigarettes in Japan. Thus, HTPs should be subjected to the same regulations as combustible tobacco products.