Abstract
Nicotine is a highly addictive substance that causes nicotine dependence, a disorder classified in the WHO
ICD-11. The DSM-5-TR also defines tobacco use disorder, and an estimated 69–89% of smokers in Japan meet criteria for this disorder. Article 14 of the WHO Framework Convention on Tobacco Control (FCTC) calls on Parties to promote tobacco cessation and treatment for tobacco dependence. Although Japan has set smoking-reduction targets through policies such as Health Japan 21, stable funding and strategic expansion of cessation services remain insufficient.
Japan has clinical guidelines and a standard procedure manual for smoking cessation treatment. However, public health insurance coverage is constrained by facility, patient, duration, and frequency requirements that are not fully evidence-based, limiting flexible access. Smoking cessation treatment during dental or inpatient care and psychological approaches such as cognitive behavior therapy and motivational interviewing remain underused.
International comparison shows more developed systems in some countries: the United States uses quitlines, online resources, and insurance-based coverage that varies by plan and state; the United Kingdom provides stop smoking services through the NHS and local authorities; and South Korea provides national smoking cessation services, including health-insurance-supported treatment and counseling. These examples highlight Japan’s limited nationwide use of quitlines and online cessation support.
Key challenges for Japan include the absence of a clear stable-financing strategy, restrictive healthinsurance
criteria, insufficient integration of evidence-based psychological interventions, limited public health campaigns to encourage cessation treatment, and the need for trained professionals. Japan should secure stable funding, expand insurance coverage, strengthen professional training including mental health collaboration, and develop nationwide telephone and online cessation-support platforms.
