Study profile: The Japan “society and New Tobacco” internet survey (JASTIS): A longitudinal internet cohort study of heat-not-burn tobacco products, electronic cigarettes, and conventional tobacco products in Japan

Background: Japan became the first country where heat-not-burn tobacco products were sold. Therefore, there was no information for actual status on the actual use status or the harms of heat-not-burn tobacco products. The objectives of the study profile are to generate data that can be freely available to external researchers, and to create collaborative research projects in the future. Methods: The Japan “Society and New Tobacco” Internet Survey (JASTIS) is a longitudinal internet cohort study which investigates perception, attitude, and use of heat-not-burn tobacco, electronic cigarettes (e-cigarettes), and conventional tobacco products in Japan. The survey also includes demographic, health-related, and socioeconomic factors. Participants were randomly selected and invited from internet panelists. The baseline survey was closed when the target number of respondents who had answered the questionnaire was met. Results: The study includes three cohorts (1-3) from the 2015 baseline survey and a cohort (4) from the 2017 baseline survey: cohorts 1 and 4 were recruited based on sex and age: men and women aged 15-69 years (n = 8,240 for cohort 1 and n = 5,897 for cohort 4); cohorts 2 and 3 were created using status-based recruiting: e-cigarette and=or heat-not-burn tobacco ever users (n = 2,188; cohort 2) and combustible cigarette smokers without e-cigarette=heat-not-burn tobacco experience (n = 724; cohort 3). The completion rates were 8.5% to 9.9%. All subjects were followed and assessed annually. Response rates for the follow-up survey were 65.5% in 2016, 55.3% in 2017, and 50.9% in 2018. Because Internet-based responders are not a representative sample of the general population of Japan, we conducted adjustment to account for “being an internet survey respondent” and reported tobacco product use in Japan. A recent JASTIS study reported that prevalence of IQOS current-use among Japanese adults had rapidly increased from 0.3% in 2015 to 3.6% in 2017. Conclusion: The JASTIS study provides the first estimates for heat-not-burn tobacco use in the world and e-cigarette use in Japan. For information on collaboration, please contact the corresponding author.