Skip to main content
Log in

Commentary: Explanations for the smoking paradox in Japan

  • Commentary
  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

The prevalence of cigarette smoking among Japanese men has been consistently high compared with Western males over the past 30 years. However, during the same period, the incidence of and mortality rates for lung cancer have consistently been lower in Japan than in Western countries (‘Japanese smoking paradox’). The odds ratio/relative risk of cigarette smoking for lung cancer mortality/incidence relative to the same number of cigarettes smoked per capita in Japan, were apparently lower than those in Western countries. This must be the cause driving the ‘Japanese smoking paradox’. Furthermore, low carcinogenic ingredients in Japanese cigarettes and a congenitally-related resistance to smoking-related lung carcinogenesis emerged as the main factors which have brought the ‘Japanese smoking paradox’.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. World Health Organization. World Health Statistics Quarterly 1988; 41: 228–41.

    Google Scholar 

  2. Marcus AC, Shopland DR, Crane LA, Lynn WR. Prevalence of cigarette smoking in the United States: Estimates from the 1985 current population survey. J Natl Cancer Inst 1989; 81: 409–414.

    Google Scholar 

  3. Tobacco control in Sweden. The National Board of Health and Welfare, 1987.

  4. World Health Organization. Tobacco or Health: A Global Status Report, March 10, 2002, URL: http:// www.cdc.gov/tobacco/who/whofirst.htm.

  5. Centers for Disease Control and Prevention. Statespecific Prevalence of Current Cigarette and Cigar Smoking Among Adults United States, 1998, March 10, 2002, URL: http://www.cdc.gov/tobacco/research_ data/adults_prev/mmwr1199fs.htm.

  6. Japan Tobacco Co. Ltd. Japan Tobacco's Annual Survey in from 1960 to 1999, 1961-2000.

  7. Vital Statistics of Japan 1997, Statistics and Information Department, Minister's Secretariat, Ministry of Health and Welfare, Tokyo, 1999. (in Japanese)

  8. IARC: Cancer incidence in five continents. Vol. VI, Parkin, DM, Muir CS, Whelan SL, Gao YT, Ferlay J, Powell J (eds), IARC Scientific Publication No. 120, Lyon, 1992.

  9. Simons LA, McCallum J, Simons J, Friedlander Y. Health status and lifestyle in elderly Hawaiian Japanese and Australian men. Exploring known differences in longevity. Med J Aust 1992; 157(3): 188–190.

    Google Scholar 

  10. Kolonel LN. Smoking and drinking patterns among different ethnic groups in Hawaii. Natl Cancer Inst Monogr 1979; 53: 81–87.

    Google Scholar 

  11. Marchand LL, Wilkens LR, Kolonel LN. Ethnic differences in the lung cancer risk associated with smoking. Cancer Epidem Biomark 1992; 1: 103–107.

    Google Scholar 

  12. Akiba S, Hirayama T. Cigarette smoking and cancer mortality risk in Japanese men and women, Results from reanalysis of the Six-Prefecture Cohort Study data. Environ Health Perspect 1990; 87: 19–26.

    Google Scholar 

  13. Segi M, Kurihara N, Ishikawa S, Haenzel W. An epidemiological survey of the relationship between lung cancer and smoking. Lung Cancer 1977; 17: 1103–112. (in Japanese).

    Google Scholar 

  14. Wynder EL, Hoffmann D. Smoking and lung cancer: Scientific challenges and opportunities. Cancer Res 1994; 54: 5284–5295.

    Google Scholar 

  15. Stellman SD, Takezaki T, Wang L, et al. Smoking and lung cancer risk in American and Japanese men: An international case-control study. Cancer Epidemiol Biomarkers Prev 2001; 10: 1193–1199.

    Google Scholar 

  16. Doll R, Peto R. The causes of cancer: Quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 1981; 66: 1191–1308.

    Google Scholar 

  17. Hegmann KT, Fraser AM, Keaney RP, et al. The effect of age at smoking initiation on lung cancer risk. Epidemiology 1993; 4: 444–448.

    Google Scholar 

  18. Sobue T, Suzuki T, Fujimoto I, et al. Case-control study for lung cancer and cigarette smoking in Osaka, Japan: Comparison with the results from Western Europe. Jpn J Cancer Res 1994; 85: 464–473.

    Google Scholar 

  19. Djordjevic MV, Eixarch L, Bush LP, Hoffmann D. A comparison of the yields of selected components in the mainstream smoke of the leading US and Japanese cigarettes. CORESTA Congress, Yokohama, Japan, 1996.

  20. Tominaga K, Saito Y, Mori K, et al. An evaluation of serum microelement concentration in lung cancer and matched non-cancer patients to determine the risk of developing lung cancer. A preliminary study. Jpn J Clin Oncol 1992; 22: 96–101.

    Google Scholar 

  21. Wynder EL, Taioli E, Fujita Y. Ecologic study of lung cancer risk factors in the US and Japan, with special reference to smoking and diet. Jpn J Cancer Res 1992; 83: 418–423.

    Google Scholar 

  22. Webb T. Green tea experiments in lab, clinic yield mixed results. J Natl Cancer Inst 2000; 92: 1038–1039.

    Google Scholar 

  23. UK Government Statistics Service. 20th Century Mortality (England & Wales 1902-1995), CD ROM, 1999.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakaji, S., Yoshioka, Y., Mashiko, T. et al. Commentary: Explanations for the smoking paradox in Japan. Eur J Epidemiol 18, 381–383 (2003). https://doi.org/10.1023/A:1024265411218

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1024265411218

Navigation