The prevalence of smoking among Japanese men decreased from over 80% in 1965 to less than 60% in 1996, but the prevalence among women remained fairly constant during that time, at about 15%. In contrast to the decreasing prevalence of smoking, the annual consumption of cigarettes and the average consumption per smoker has been increasing for decades. The burden of tobacco use on the health status of the Japanese should therefore be evaluated by taking into account not only smoking prevalence but also daily cigarette consumption per smoker. We propose the use of a measure, the ‘cumulative cigarette consumption’, for estimating life-long cumulative exposure to tobacco smoke. The cumulative cigarette consumption can be calculated by adding up the annual, age-specific consumption of cigarettes of a specific birth cohort. The death rate from lung cancer was found to correlate linearly with cumulative cigarette consumption. Tobacco control in Japan is also discussed, with emphasis on the prevention of smoking among minors.
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