Observational studyTobacco control2025
Evaluating trends in cigarette and HTP use in Japan and measurement issues in the National Health and Nutrition Survey.
Observational study in Tobacco control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Differential impact of South Korea's 2019 E-cigarette advisory on adult tobacco product use: an interrupted time series analysis by product type and subgroup.BMC public health · 2026Article
- Global Heated Tobacco Product User Estimates, 2014-2024: Descriptive Surveillance Study Using Manufacturer Disclosures.JMIR public health and surveillance · 2026Article
- Recent Trends in Cigarette and HTP Use in Japan: A Scoping Review.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Transformation of the tobacco product market in Japan, 2011-2023.Tobacco control · 2026Article
- Changes in Smoking Patterns and Cervical Cancer Risk: Preventive Implications from a Nationwide Japanese Cohort.Healthcare (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
introdutionStudies have reported that the rapid rise in heated tobacco product (HTP) sales in Japan accompanied an accelerated decline in cigarette sales. However, these studies do not distinguish whether those who previously smoked cigarettes became dual users with HTPs (smoking fewer cigarettes) or instead switched completely to HTPs. If HTPs present lower health risks than cigarettes, replacing cigarettes with HTPs is more likely to improve public health than cigarette users continuing as dual users.
methodsTo evaluate the role of HTP introduction relative to smoking prevalence, we examine trends in cigarette prevalence as related to trends in HTP use using Japan's National Health and Nutrition Survey (NHNS) from 2011 to 2019. We develop measures of relative changes in smoking prevalence use by age and gender in the pre-HTP and post-HTP periods. We then analyse prevalence data by year using joinpoint regression to statistically distinguish changes in trend.
resultsCompared with the pre-HTP 2011-2014 period, cigarette prevalence decreased more rapidly during the post-HTP 2014-2017 period, particularly among younger age groups. However, the changing format of NHNS questions limits our ability to determine the impact on smoking prevalence, particularly after 2017.
conclusionsWhile suggesting that HTPs helped some people who smoke to quit smoking, this study also shows the difficulties in eliciting accurate survey responses about product use and distinguishing the impact of a potentially harm-reducing product in an environment subject to rapidly evolving patterns of use.
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