Prevalence and patterns of tobacco and/or nicotine product use in Japan (2017) after the launch of a heated tobacco product ( ): a cross-sectional study.

Several smoke-free tobacco and/or nicotine-containing products (TNP) have emerged in recent years to support tobacco harm reduction strategies and reduce individual health risks and population harm relative to continued cigarette smoking. This paper describes the nationwide prevalence and patterns of TNP use in Japan following the commercialization of one such smoke-free TNP, the heated tobacco product ® (Philip Morris International).   We analyzed the first annual data (2016-2017) of two repeated cross-sectional surveys conducted in a representative sample of the Japanese general adult (≥20 years of age) population (N = 4,878) and a sample of adult users (N = 2,000). We assessed the prevalence of current TNP use according to type of product (cigarettes, , e-cigarettes, and other TNPs) in the general population and patterns of TNP use in the user sample. The prevalence of current use across all TNP in the sampled general population was 18.5% (95% confidence interval 17.2-19.5%), with 17.5% (16.4-18.6%) for cigarette smoking and 1.8% (1.4-2.2%) for use. Regarding the distribution of patterns of use in the user survey, the majority (63.4% [61.2-65.6%]) were exclusive users of , followed by 20.6% (18.7-22.5%) of individuals who reported dual use of and cigarettes. In Japan, cigarette smoking remains the most prevalent way of consuming TNP; however, is being adopted by a growing number of adult Japanese smokers. These findings serve as baseline data for monitoring trends over time in the use and adoption of potential smoke-free TNP in Japan.