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Use of heated tobacco products in smoke-free locations in Japan: the JASTIS 2019 study
  1. Kosuke Kiyohara1,
  2. Takahiro Tabuchi2
  1. 1Department of Food Science, Otsuma Women's University, Tokyo, Japan
  2. 2Cancer Control Center, Osaka International Cancer Institute, Osaka, Osaka, Japan
  1. Correspondence to Dr Kosuke Kiyohara, Department of Food Science, Otsuma Women's University, 12 Sanbancho, Chiyoda-ku, Tokyo, 102-8357, Japan; kiyosuke0817{at}


Objective We aimed to examine the use of heated tobacco products (HTPs) in locations where cigarette smoking was not allowed, and to explore the factors associated with such use among Japanese HTP users.

Methods An internet-based self-reported questionnaire survey was conducted in 2019 as part of the Japan Society and New Tobacco Internet Survey. The study subjects were respondents who self-reported having used HTPs in the last year. The proportions of those who had ever used or frequently used HTPs in locations where tobacco smoking was not allowed in the last year were calculated. These locations included home, restaurants and workplaces. Furthermore, potential factors associated with HTP use in such smoke-free locations were examined using multivariable logistic regression analyses.

Results The proportion of HTP users who had ever used HTPs in smoke-free locations in the last year was 20.7% (148/716) at home, 11.8% (128/1081) in restaurants and 11.9% (113/950) in workplaces. The proportion of those who had frequently used HTPs in those locations was 9.5% (68/716) at home, 4.8% (52/1081) in restaurants and 8.0% (76/950) in workplaces. The statistically significant factors associated with HTP use varied by location. Generally, respondents who thought HTP use was not forbidden in places where tobacco smoking is forbidden were likely to use HTPs in such locations.

Conclusion In Japan, a considerable number of people used HTPs in locations where tobacco smoking was not allowed. Policymakers should establish clear rules about use of HTPs in smoke-free environments.

  • non-cigarette tobacco products
  • public policy
  • surveillance and monitoring

Statistics from


  • Contributors TT had full access to all of the study data and takes responsibility for the integrity of the data and the accuracy of the data analysis. Both the authors were involved in the study concept and design and analysis and interpretation of data. Acquisition of data was performed by TT. Drafting of the manuscript and critical revision of the manuscript for important intellectual content was done by KK and TT. Statistical analysis was performed by KK. Study supervision was done by TT.

  • Funding The study is supported by Health Labour Sciences Research Grants (20FA1005; 19FA0501; 19FA2001; and 19FA1011) and the Japan Society for the Promotion of Science (JSPS) KAKENHI Grants (18H03062).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was reviewed and approved by the Research Ethics Committee of the Osaka International Cancer Institute (no. 1412175183).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. The JASTIS data can be accessed via the principal investigator, Takahiro Tabuchi, upon reasonable request.

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