2025-10-15 国立循環器病研究センター
<関連情報>
- https://www.ncvc.go.jp/oic/topics/topics_5126/
- https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2840045
日本における加熱式タバコ製品の普及と急性冠症候群による入院 Heated Tobacco Product Spread and Hospitalizations for Acute Coronary Syndrome in Japan
Yoshitaka Iwanaga, MD, PhD; Michikazu Nakai, PhD; Yoshihiro Miyamoto, MD, PhD;et al
JAMA Network Open Published:October 14, 2025
DOI:10.1001/jamanetworkopen.2025.37334
Introduction
Heated tobacco products (HTPs) have gained traction as alternatives to conventional cigarettes, particularly among young adults (aged 20-49 years) in Japan, with more than 50% of young smokers using HTPs.1 Although HTP use may be associated with a reduction in exposure biomarkers for cardiovascular disease compared with conventional cigarettes,2 little is known about whether HTP use is associated with cardiovascular events. Although previously shown to have no association with acute coronary syndrome (ACS) hospitalizations during the 3 years after HTP introduction in Japan,3 we explored whether an association exists since HTP use has expanded.
Methods
This cohort study used Japanese Registry of All Cardiac and Vascular Disease–Diagnosis Procedure Combination data from April 1, 2013, to March 31, 2022.4 The study was approved by the Hyogo Prefecture Amagasaki General Medical Center Ethics Committee with a waiver of informed consent as the data were publicly available and deidentified. The study followed the STROBE reporting guideline.
Longitudinal trends of admissions for ACS across Japan were examined. Interrupted time-series analysis was performed, with the level and trend changes after 2017 evaluated. The slope and 95% CI were calculated with seasonal adjustment, using a significance level of P < .05 (eMethods in Supplement 1). The data were analyzed between January 17 and May 20, 2025, using Stata, version 16 (StataCorp LLC).
Results
Hospitalizations of 370 178 patients with ACS across 300 hospitals were analyzed (mean [SD] age, 70.5 [12.5] years, 72.1% men and 27.9% women). No significant change was observed between before and after the introduction of HTPs in total ACS hospitalizations (slope change, -4.01; 95% CI, -12.54 to 4.52) (Figure). However, when limited to patients aged 20 to 49 years, the trend started to decrease after introduction of HTP (slope change, -1.33; 95% CI, -1.82 to -0.85). In patients who smoked, a similar change was observed (slope change, -5.14; 95% CI, -8.20 to -2.07). Significant changes were also found in the Tokyo (slope change, -2.69; 95% CI, -4.01 to -1.36) and 10 prefecture (slope change, -3.99; 95% CI, -7.23 to -0.75) areas with higher HTP prevalence. Conversely, there were no changes among older patients, nonsmokers, and the 10 prefectures with lower HTP prevalence.
