Why Japan’s Huge Drop in Smoking Is a Story Prohibitionists Ignore

May 13, 2021

Nowhere on Earth has cigarette consumption dropped as rapidly as it has in Japan over the past few years.

Just look at the numbers: In the first quarter of 2021—January, February and March of this year—domestic cigarette sales in Japan totaled about 25 billion sticks. In 2016, that same period saw around 43.6 billion domestic cigarette sales in the country. There has been close to a 43 percent decline in half a decade.

It is an extraordinary success. And it seems attributable to a single shift: Japan’s population of smokers, with the government’s acquiescence, has embraced heated tobacco products (HTPs), which heat tobacco sticks to produce vapor—not smoke—that is inhaled.

There are currently at least three such products on the Japanese market, with the first introduced in 2014, and Japan has become a testing ground of sorts. Market analyst reports estimate that Japan has the world’s biggest HTP market, with 85 percent of global sales in 2018. Nearby countries—notably South Korea—have followed suit by making HTPs available, also seeing cigarette sales fall.

According to Barclays investor research reviewed by Filter, HTPs have become a growing worry for Japan Tobacco International (JTI), which has around a 60 percent share of Japan’s cigarette market (even though its own HTP, Ploom Tech, is one of the three devices available in Japan). The company has been losing market share and its stock price has dropped.

Critics of mainstream tobacco control—which tends to favor prohibition-centered measures on lower-risk products—point to Japan as a potential model for nations around the world. And that’s despite the Japanese example being flawed and somewhat limited: HTPs may be ubiquitous, but vaping products are effectively outlawed. Unlike the United States, Japan is a party to the World Health Organization’s Framework Convention on Tobacco Control. Though the WHO includes “harm reduction strategies” in its definition of “tobacco control,” it has not yet definitively embraced vaping or the use of HTPs.

Japan’s success nonetheless has been widely ignored by anti-smoking organizations like the Michael Bloomberg-funded Campaign for Tobacco-Free Kids and leading health agencies like the WHO. The reason, many tobacco harm reduction proponents insist, is because manufacturers, and not necessarily the public health community, are the ones driving the change. There has not been any real educational campaign on reduced-risk products by the government, for example.

“Smoking has never dropped that fast. It is very odd that the tobacco control community is not more interested in finding out why.”

“The iron rule of tobacco control mythology is that the tobacco industry and public health must always be in a fundamental and irreconcilable conflict,” Clive Bates, a tobacco control expert from the United Kingdom, told Filter. “So the astonishing changes we see in Japan have to be explained away or ignored, or their story falls apart.”

“There can be no question: HTPs have caused cigarette sales to plummet in Japan,” Dr. Charles A. Gardner, the executive director of INNCO, a global nonprofit that supports the rights and well-being of adults who use safer nicotine, told Filter. “In all of human history, smoking has never dropped that fast. It is very odd that the tobacco control community is not more interested in finding out why.”

Switching from combustible cigarettes to HTPs reduces your exposure to chemicals that cause harm. We don’t need to ask the companies that make HTPs: The US Food and Drug Administration (FDA) agrees. In July 2020, the FDA authorized Philip Morris to market IQOS, another one of the devices available in Japan, as a “modified risk product” in the States. The authorization allows the manufacturer to state the following: firstly, that the IQOS system heats tobacco but doesn’t burn it; secondly, that it “significantly reduces the production of harmful and potentially harmful chemicals;” and, lastly, that “scientific studies have shown that switching completely from conventional cigarettes to the IQOS system significantly reduces your body’s exposure to harmful or potentially harmful chemicals.”

“We too are astonished that more people in the tobacco control community aren’t viewing the situation in Japan as a tremendous breakthrough,” Dr. Moira Gilchrist, the vice president of strategic and scientific communications at Philip Morris International (PMI), told Filter. “It’s a real world example, on a massive scale, of what happens when a company gets it right on science and on product, and when governments allow innovation to thrive. Japanese adults are voting with their feet and leaving cigarettes—in droves. There is no good reason why the continuing success in Japan can’t be replicated in every country.”

Smoking remains the number one cause of preventable death in the world, and despite the FDA’s HTP authorization, the US is far behind in addressing this issue. According to numerous public health authorities, like the UK’s Royal College of Physicians and the US National Academies of Science, Engineering and Medicine, vaping products are far less harmful than combustible cigarettes. But concerns over youth e-cigarette use and “EVALI”—eventually linked by the Centers for Disease Control and Prevention (CDC) to vitamin E acetate, found in some illicit THC cartridges—coalesced into a fundamental misunderstanding of the reduced risks of vaping compared with smoking, and in 2020, cigarette sales in the States actually increased.

Meanwhile, more and more people in Japan are rejecting cigarettes and choosing alternative products that have been made widely available.

“The model that is being used by the anti-tobacco people globally, with dollops of money from Bloomberg, is the US approach,” David Sweanor, a tobacco industry expert and chair of the Advisory Board for the Centre for Health Law, Policy, and Ethics at the University of Ottawa, told Filter. “This information from Japan is totally available. It looks far more like religious belief. It’s not just that people aren’t looking at this. They refuse to look at it, and they refuse to discuss it.” 

“All Japan has done, really, is not obstruct the efforts for this single category, and still we have the most rapid decline is cigarette sales that we’ve ever seen,” Sweanor said. “It raises the question: What could we accomplish?

 


 

Update, May 13: This article has been edited to clarify the FDA’s position on HTPs.

PMI has provided unrestricted grants to The Influence Foundation, which operates Filter. Both INNCO and The Influence Foundation have received grants from the Foundation for a Smoke-Free World. Filter’s Editorial Independence Policy applies.

Photograph by Vaping360 via Flickr/Creative Commons 2.0

Alex Norcia

Alex is a staff writer at Filter. He previously worked as a reporter and copy editor at VICE, and has been published in The New York Times MagazineThe Columbia Journalism ReviewThe Nation and The Daily Beast, among other outlets. He is also a freelance editorial consultant for the Foundation for a Smoke-Free World; The Influence Foundation, which operates Filter, has received both restricted and general support grants from the Foundation for a Smoke-Free World. Alex is currently based in Phoenix, Arizona.

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