Towards A Smoke-Free Future: Lessons From Japan

According to Philip Morris International, the decrease in cigarette sales in Japan observed in recent years holds valuable lessons for public health.

Cigarette smoking is known to cause a variety of serious illnesses, such as heart disease and cancer. It has been estimated that around eight million deaths happen each year globally.

Efforts to prevent people from smoking and support those who are trying to stop are key to reducing the harm caused by tobacco use. The best option for a smoker is to quit but, unfortunately, many people still choose to smoke.

For those who still continue to smoke, the opportunity to switch to scientifically substantiated, better alternatives may be the key to accelerating the decline in the number of people who smoke. According to the WHO, there are more than one billion smokers in the world today, and this number is expected to stay steady until 2025.

Many people believe that nicotine is the main issue when it comes to the harms of smoking, but the evidence tells us this is not correct.

Although nicotine is addictive and not without risk, it is not the main cause of smoking-related diseases. In fact, the toxic chemicals in the smoke that is generated when tobacco is burned is the main problem.

In some countries, such as the U.K. and New Zealand, the use of regulated novel tobacco and nicotine products is seen as an appropriate alternative for smokers who do not quit, and their use is encouraged by public health bodies.

A country that merits attention is Japan, where, despite the lack of formal harm reduction policies to encourage switching, many smokers have switched to novel nicotine products such as e-cigarettes and heated tobacco. In just six years since the introduction of heated tobacco products in 2014, tobacco heating system IQOS has grown year on year, achieving more than a 20% share of the market.

A study conducted by researchers from the American Cancer Society revealed that the decline in cigarette sales in Japan followed the introduction of heated tobacco products in the country. The researchers applied multiple alternative causation models to the sales figures, including pricing and legislation, but found it difficult to explain the decline in cigarette sales without factoring in the introduction of heated tobacco products. The study concluded that heated tobacco products ‘likely reduced cigarette sales in Japan’.

A second, independent study by the International Journal of Environmental Research and Public Health reported that between 2015 and 2019, total cigarette sales dropped by 34% in Japan, while the sales of heated tobacco products increased from 5.1 billion sticks to 37.1 billion. The study concluded that, “the accelerated decline in cigarette only sales since 2016 corresponds to the introduction and growth in the sales of heated tobacco products.”

The decline in cigarette sales in Japan can serve as inspiration for other countries to pursue similar goals. With the right regulatory encouragement, societal support, and innovative, science-based reduced harm alternatives, a future without cigarettes is entirely possible.