Objective:
Recently the number of adults who smoke e-cigarette (EC) and/or heat-not-burn tobacco (HNBT) has been increasing in Japan. It is important to clarify the awareness of them and actual status of their use among Japanese students.

Methods:
In 2018, the author conducted questionnaire surveys in six primary schools and four junior high schools, and asked the students if they knew EC and HNBT (IQOS, PloomTECH, Glo). The degree of recognition was classified into four categories; A: ”never know”, B: ”only know the name”, C: ”have seen the item”, and D: ”my family member(s) smoke(s)”.

Results:
Responses were obtained from 593 schoolchildren (5th and 6th grades) and 584 junior high school students (7th and 8th grades), and the results were as follows. Among schoolchildren about EC, A:47.6%, B:28.7%, C:17.6%, D:6.1%, and about IQOS, A:49.1%, B:14.8%, C:15.1%, D:21.0%. Among students about EC, A:35.3%, B:36.8%, C:22.6%, D:5.3%, and about IQOS, A:53.2%, B:17.8%, C:17.0%, D:12.0%. As for Ploom TECH and Glo, nearly 90% of them answered “A”.

Conclusions:
About half of the schoolchildren and the students knew EC and IQOS. It may reflect the popularity of them in Japanese society. Smoking rate of combustible cigarette in Japanese junior high school students has been dramatically decreasing in these 20 years. The first and nationwide data of their smoking rate of EC and HNBT were reported from the Japanese Youth Tobacco and Alcohol Surveys in 2018. It revealed that the rates of smoking experience of EC were 2.4% in male students and 1.7% in females, and those of HNBT were 1.3% in males and 0.9% in females. As for cigarette, 3.1% in males and 2.1% in females. Since there’s a possibility that more students will start to smoke EC and HNBT, anti-smoking education should include information about the risk of EC and HNBT.