Evidence map›Paper›PMID 39419609›Full record

ArticleTobacco control2026

Impacts of revised smoke-free regulations under the 2020 Japan Health Promotion Act on cigarette smoking and heated tobacco product use in indoor public places and homes: findings from 2018 to 2021 International Tobacco Control (ITC) Japan Surveys.

Kayo Togawa, Geoffrey T Fong, Anne C K Quah, Gang Meng, Steve S Xu, Janine Quimet, Yumiko Mochizuki, Itsuro Yoshimi, Satomi Odani, Takahiro Tabuchi and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Tobacco control, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. 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 · 2026
    Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kayo TogawaDivision of Population Data Science, National Cancer Center Institute for Cancer Control, Tokyo, Japan togawak@iarc.who.int.ORCID 0000-0001-6470-7775
Geoffrey T FongDepartment of Psychology, University of Waterloo, Waterloo, ON, Canada.
Anne C K QuahDepartment of Psychology, University of Waterloo, Waterloo, ON, Canada.
Gang MengDepartment of Psychology, University of Waterloo, Waterloo, ON, Canada.ORCID 0000-0002-7771-7881
Steve S XuDepartment of Psychology, University of Waterloo, Waterloo, ON, Canada.
Janine QuimetDepartment of Psychology, University of Waterloo, Waterloo, ON, Canada.
Yumiko MochizukiShinmachi Clinic and Health Care Center, Tokyo, Japan.
Itsuro YoshimiCentre for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo, Japan.
Satomi OdaniDepartment of Cancer Epidemiology, Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.ORCID 0000-0002-6263-4952
Takahiro TabuchiDivision of Epidemiology, School of Public Health, Tohoku University Graduate School of Medicine, Miyagi, Japan.
Kota KatanodaDivision of Population Data Science, National Cancer Center Institute for Cancer Control, Tokyo, Japan.

Funding

Vaporized Nicotine Product Initiation Among Youth in the US, Canada, and England: Methods to Predict Uptake and Policy EfficacyP01CA200512 · NCI · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI FONG, GEOFFREY T · 2016 to 2025
$25.3M
NCI NIH HHS P01 CA200512World Health Organization 001
6 · The paper itself

Abstract

backgroundIn April 2020, Japan's revised Health Promotion Act (HPA) banned cigarette smoking and heated tobacco products (HTP) use in indoor public places but exempted small establishments and permitted smoking-designated/HTP-designated rooms. This pre-post study evaluated the effectiveness of the HPA.

methodsData were from waves 1 to 4 (2018-2021) of the International Tobacco Control Japan Surveys among a national cohort of adults who smoke cigarettes, use HTPs and do not use any tobacco products. The sample sizes in the respective surveys were 4615, 4222, 4387 and 4254. Multivariable logistic regression models employing generalised estimating equations estimated the prevalence of observed and self-reported indoor smoking/HTP use in key public venues (restaurants/cafés, bars/pubs and workplaces), smoke-free places, and homes, and smoke-free/HTP aerosol-free home policies (model 1). The models were additionally adjusted for waves 1-4 to estimate the impacts of the HPA (model 2).

resultsThe implementation of the HPA significantly reduced observed indoor smoking in bars/pubs (model 1: 82.2% (pre) to 55.5% (post), model 2: p=0.04) but not in restaurants/cafés (model 1: 53.0%-24.9%, model 2: p=0.15) or workplaces (model 1: 35.3%-30.1%, model 2: p=0.62). Observed indoor HTP use was also common postimplementation (restaurants/cafés: 19.6%, bars/pubs: 53.9%, workplaces: 36.4%). The implementation of the HPA was associated with a significant increase in observed HTP use in smoke-free places (model 1: 26.3%-33.3%, model 2: p=0.001) and a suggestive increase in homes without HTP aerosol-free policies among adults who smoke (model 1: 64.0%-77.0%, model 2: p=0.09).

conclusionsThe implementation of the HPA was limited in its effectiveness. Comprehensive regulations with no exemptions are needed in Japan.

Indexed as

Cigarette SmokingHealth PromotionPublic FacilitiesSmoke-Free PolicyTobacco ProductsTobacco Smoke PollutionAdultFemaleHumansJapanMaleMiddle AgedRestaurantsSurveys and QuestionnairesTobacco ControlWorkplaceTobacco Smoke PollutionNon-cigarette tobacco productsPublic policySecondhand smoke

Identifiers

PMID39419609
PMCPMC12003691

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.