EXAMINING JAPAN’S ADOPTION OF HARM REDUCTION STRATEGIES FOR PUBLIC HEALTH


Another smoke-free alternative is snus, an oral tobacco product which is usually either in a loose form or in portioned sachets, and is predominantly used in Sweden and Norway.

JAPAN’S decline in cigarette sales over the past years can be attributed to the pioneering adoption of heated tobacco systems (THS).

The uptake of heated tobacco products (HTPs) in Japan has been accompanied by sharp declines in cigarette sales.

In fact, according to the latest industry report from the Tobacco Institute of Japan, cigarette consumption decreased by 44% within five years after the introduction of the THS – the highest decline that Japan has ever had.

Alternatives have proven to play an important role in decreasing the rate of smoking prevalence in a given country. Take Sweden as another example – It has been reported that the use of snus as an alternative played an important role in decreasing smoking prevalence in the country, especially among men, while also lowering the rate of lung cancer and heart attacks among men in Sweden.

The science behind heating

At the core of the heated tobacco alternatives is the science that sets it apart from traditional cigarettes.

Instead of combustion which generates harmful and potentially harmful chemicals, tar and smoke, heated tobacco systems employ precise heating mechanisms that deliver on the traditional experience of tobacco without emitting the toxic byproducts of combustion.

This shift is not merely cosmetic but a profound reduction in harm.

PMI chief medical officer Dr Patrick Picavet said, “Of course, the best option for a smoker would be to quit but unfortunately, that’s not the reality.

“The reality is that people continue and therefore, you would need an alternative which is less harmful if you want to reduce individual risk as well as population harm.”

According to the concept of tobacco harm reduction, reducing tobacco-related harm at the macro population level depends on the adoption of less harmful smoke-free alternatives by adult smokers.

HTPs have gained recognition for their potential to be less harmful compared to continued smoking, thanks to the absence of smoke and significantly reduced levels of harmful chemicals.

Japan’s declining smoking rate

The reduction in cigarette sales in Japan is closely linked to the adoption of heated tobacco systems, emphasising the impact of scientific advancements.

In a reduced emission study published in the Journal of UOEH (University of Occupational and Environmental Health in Japan), the country’s National Institute of Public Health (NIPH) concluded that, “the concentrations of nicotine in tobacco fillers and the mainstream smoke of IQOS were almost the same as those of conventional combustion cigarettes, while the concentration of tobacco-specific nitrosamines (TSNAs) was one fifth and carbon monoxide (CO) was one hundredth of those of conventional combustion cigarettes.”

Data from the Japanese government’s National Health and Nutrition Survey revealed that the most frequent pattern of use of HTPs in Japan is “exclusive use”.

An overwhelming majority of HTP users (76% in 2019) did not report any cigarette smoking, further emphasising the potential of HTPs to lead to reduced smoking prevalence [1].

Adult smokers nowadays are already turning to alternatives as the public is more than aware of the dangers of traditional smoking.

This shift in behaviour also reflects a broader global trend where consumers seek alternatives that offer a better choice than cigarettes, thanks to science-driven innovations.

Malaysia’s vape industry, however, still needs clearer regulations and guidelines to tackle youth vaping.

Regulatory support and scientific rigour

One critical aspect of Japan’s regulatory support is the recognition of heated tobacco products (HTPs) as a distinct category separate from traditional cigarettes. This distinction allowed for tailored regulations that encouraged innovation and reduced barriers to entry for safer alternatives.

At the same time, Japan’s regulatory authorities worked hand-in-hand with the tobacco industry to establish clear product standards, disclosure requirements and health warnings. This collaborative approach fostered transparency and consumer confidence, promoting the uptake of HTPs.

Meanwhile, Japan’s Ministry of Health, Labour, and Welfare played a pivotal role in educating the public about the relative risks of HTPs compared to traditional cigarettes.

They based their messaging on scientific research and conducted extensive public awareness campaigns. This approach helped to dispel misconceptions and encourage adult smokers to consider switching to HTPs as a less harmful alternative [2].

The totality of the evidence available today from numerous rigorous scientific assessments and programmes indicates that switching completely to THS, while not risk-free, presents less risk of harm than continued smoking.

References:

1. Why did cigarette sales decline in Japan?; https://www.pmiscience.com/en/research/publications-library/effect-of-switching-from-cigarette-smoking-to-the-use-of-the-tob/

2. The story of THS in Japan, an interview with Tomoko Iida; https://www.pmiscience.com/en/news-events/scientific-update-magazine/the-story-of-ths-in-japan--an-interview-with-tomoko-iida-/

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