Nationwide trends in cigarette, heated tobacco product, e‐cigarette, and multiple‐product use in Japan 2017–2025

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Abstract Aim To describe nationally representative trends in overall and product‐specific tobacco use, including cigarettes, heated tobacco products (HTPs), and electronic cigarettes (e‐cigarettes), in Japan from 2017 to 2025. Methods Data came from repeated cross‐sectional nationwide surveys of the Japanese population using stratified two‐stage random sampling. Self‐administered questionnaires assessed tobacco use. Past‐30‐day prevalence of overall, product‐specific, and multiple‐product use was estimated using survey‐weighted logistic regression, with marginal predicted prevalence standardized to the 2025 age–sex structure. Results Among 16,499 participants, overall past‐30‐day tobacco use declined from 24.3% (95% confidence interval [CI]: 22.6–26.0%) in 2017 to 21.0% (CI: 19.4–22.7%) in 2025. Cigarette use decreased from 20.7% (CI: 19.0–22.3%) to 12.3% (CI: 11.1–13.6%), whereas HTP use increased from 5.3% (CI: 4.4–6.1%) to 11.7% (CI: 10.3–13.0%). e‐cigarette use remained low, ranging from 0.7% to 1.3%. The most common multiple‐product pattern was concurrent cigarette and HTP use, increasing from 2.5% (CI: 1.9–3.1%) to 4.1% (CI: 3.3–4.9%). Conclusion Overall tobacco use in Japan declined modestly during 2017–2025, alongside a marked decrease in cigarette use and an increase in HTP use, while e‐cigarette use remained limited. These findings suggest a shift in tobacco use, with increased HTP use partially offsetting reductions in cigarette smoking.