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Japan’s Perceptions of Health Risks From Heated Tobacco vs Cigarettes

Japan is the world's ninth largest cigarette market, and sadly still has very high smoking rates. The current study aimed to determine smokers’ perceptions of the health risks from using heated tobacco products (HTPs) as compared to smoking combustible cigarettes.

Diane Caruana

May 21, 2020

The study titled, “Perceptions of Harmfulness of Heated Tobacco Products Compared to Combustible Cigarettes among Adult Smokers in Japan: Findings from the 2018 ITC Japan Survey,” was published in the International Journal of Environmental Research and Public Health in April.

This study examined Japanese smokers’ harm perceptions of HTPs relative to combustible cigarettes, and the differences in these perceptions between exclusive smokers and dual users (smokers who also use HTPs). Additionally, the researchers looked into the impact that marketing and advertising had on these perceptions.

This cross-sectional study gathered data from 2614 adult exclusive cigarette smokers and 986 dual users. The participants were asked to report their perceptions of harmfulness of HTPs compared to cigarettes, as well as their exposure to HTP advertising in the last six months.

47.5% of smokers believe that heated tobacco is safer than cigarettes

24.6% perceived HTPs to be as equally harmful as cigarettes,1.8% perceive HTPs as more harmful, and 26.1% did not know.

The compiled data indicated that among all smokers, 47.5% perceived HTPs as less harmful than cigarettes, 24.6% perceived HTPs to be equally harmful, 1.8% perceive HTPs as more harmful, and 26.1% did not know.

Dual users were more likely than exclusive smokers to believe that HTPs are less harmful (62.1% versus 43.8%, p < 0.0001) and they were less likely to report that they did not know (14.3% versus 29.4%, p < 0.0001).

Frequent users more likely to believe that HTPs are safer

Frequent HTP users were more likely than infrequent users to believe that HTPs are less harmful (71.7% versus 57.1%, p ≤ 0.001), and adverts also seemed to have a positive effect on the participants’ perceptions. “Believing that HTPs are less harmful than cigarettes was associated with noticing HTP advertising on TV (p = 0.0005), in newspapers/magazines (p = 0.0001), on posters/billboards (p < 0.0001), in stores where tobacco (p < 0.0001) or where HTPs (p < 0.0001) are sold, on social media (p < 0.0001), or in bars/pubs (p = 0.04).”

The researchers concluded that HTP users were significantly more likely than non users to believe that the products were safer than regular cigarettes, with this belief being more prominent among frequent users. Similarly smokers who had been exposed to advertising, were more likely to perceive HTPs as less harmful than cigarettes.