Objectives: Differences have been noted in smoking rate among the 47 prefectures in Japan. One reason for this may be that smoking rate is lower in areas where smokers are more likely to receive support for smoking cessation from healthcare professionals. However, the extent of smoking cessation counseling pharmacies in proportion to pharmacies in each prefecture has not yet been clarified. Therefore, this study investigated the relationship between smoking rate and the number of smoking cessation consultation pharmacies in each prefecture.
Method: The number of registered pharmacies in each prefecture offering smoking cessation counseling (as of December 31, 2022) was collected. Spearman’s rank correlation coefficient (rs) was calculated to examine the relationship between the smoking rate and the proportion of pharmacies providing smoking cessation counseling relative to the total number of pharmacies in each prefecture. Additionally, multiple regression analysis was performed after adjusting for confounding factors affecting smoking rates, including the number of pharmacies and medical institutions per 100,000 people in each prefecture, as well as the proportion of outpatient clinics with smoking cessation counseling.
Results: The average percentage of smoking cessation counseling pharmacies among the total number of pharmacies in each prefecture was 61%, with Ishikawa Prefecture having the highest percentage at 95%; only one listed pharmacy was present in Okinawa Prefecture. Prefectures with large numbers of smoking cessation counseling pharmacies tended to have a lower smoking rate (rs = −0.353, p = 0.02). Multiple regression analysis with a single correlation coefficient of p < 0.1 as explanatory variables yielded similar results (standard regression coefficient: −0.025, p = 0.04).
Conclusions: Overall, a negative correlation was found between the proportion of smoking cessation counseling pharmacies in each prefecture and the smoking rate. To reduce the regional gaps in the smoking cessation support opportunities, promoting the training of pharmacists who can provide smoking cessation counseling is desirable, especially in prefectures with high smoking rates. In order for residents/patients to choose appropriate pharmacies when attempting to quit smoking, unifying the smoking cessation support information on the Medical Navigation Search website of each prefecture is necessary.

Under the supervision of a senior fellow specialist of MI for Tobacco Control who specializes in Motivational Interviewing (MI), two case studies were conducted with two smokers, Smoker A and Smoker B. The online interviews used MI, which is a method known to be effective for smoking cessation. The verbatim transcripts of the interviews were reviewed with the aim of clarifying how the content of the conversations affected the two cases that followed the process of starting and continuing smoking cessation. The method involved conducting five interviews over approximately three months using MI, followed by supervision sessions for reflection and preparation before each subsequent interview.
The results showed that conversations aimed at establishing a relationship by linking the smoker’s important values to smoking cessation through the “engagement process” and eliciting reasons for the persistent ambivalence towards quitting smoking facilitated change talk and increased confidence levels. The supervision played a role in structuring the interviews, preparing for individualized maintenance talk, and improving subsequent interviews based on individual needs. In the future, it is necessary to accumulate data that includes cases where smoking cessation was not achieved and extract factors influencing smoking cessation.