{
  "abstract": "Objective This study updates a previous paper that examined trends in the sale of cigarettes and heated tobacco products (HTPs) in Japan between 2011 and part way through 2019. The current study includes complete unit sales data through 2023.Methods Data on cigarette and HTP sales were obtained from public sources available from the websites and stockholder reports for the Tobacco Institute of Japan, Philip Morris International and Japan Tobacco. We used joinpoint regression using the parametric method to test for trends in both per capita and total sales for the three outcome variables assessed between 2011 and 2023: (1) cigarette sales, (2) HTP sales and (3) combined cigarette and HTP sales. Joinpoint regression identifies changes in trends and estimates the annual per cent change (APC) for each trend segment.Results Between 2011 and 2023, per capita and total cigarette sales declined by 52.6% and 52.7%, respectively. From 2011 to 2015, per capita cigarette sales in Japan decreased −1.5% APC; from 2015 to 2018, the decline accelerated to −10.5% APC and continued to fall −7.3% APC between 2018 and 2023. Between 2016 and 2018, per capita HTP sales increased by 149.0% APC, and since 2018, they have increased by 8.1% APC.Conclusion While many factors may account for the decreased sale of cigarettes in Japan over the past 12 years, the increased sale of HTPs appears to be a factor.",
  "authors": [
    {
      "affiliations": [
        "Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA"
      ],
      "name": "K Michael Cummings"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA"
      ],
      "name": "Avery Roberson"
    },
    {
      "affiliations": [
        "Lombardi Comprehensive Cancer Center, Georgetown University, Washinton, District of Columbia, USA"
      ],
      "name": "David T Levy"
    },
    {
      "affiliations": [
        "Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada",
        "School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada"
      ],
      "name": "Rafael Meza"
    },
    {
      "affiliations": [
        "Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan, USA"
      ],
      "name": "Kenneth E Warner"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada",
        "Ontario Institute for Cancer Research, Toronto, Ontario, Canada"
      ],
      "name": "Geoffrey T Fong"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada"
      ],
      "name": "Steve Shaowei Xu"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada"
      ],
      "name": "Shannon Gravely"
    },
    {
      "affiliations": [
        "The University of Melbourne School of Psychological Sciences, Melbourne, Victoria, Australia",
        "Department of Health Policy, National Center for Child Health and Development, Setagaya-ku, Japan"
      ],
      "name": "Bibha Dhungel"
    },
    {
      "affiliations": [
        "The University of Melbourne School of Psychological Sciences, Melbourne, Victoria, Australia",
        "Deakin University School of Psychology, Burwood, Victoria, Australia"
      ],
      "name": "Ron Borland"
    },
    {
      "affiliations": [
        "Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA"
      ],
      "name": "Richard J O'Connor"
    },
    {
      "affiliations": [
        "Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA"
      ],
      "name": "Maciej Lukasz Goniewicz"
    },
    {
      "affiliations": [
        "Faculty of Law, University of Ottawa, Ottawa, Ontario, Canada"
      ],
      "name": "David T Sweanor"
    }
  ],
  "title": "Transformation of the tobacco product market in Japan, 2011–2023",
  "uid": "ea0284b4-cd4b-5b1b-82b6-ffc1b30cf6d7"
}