Background and challenges to implementation:
Japan was chosen by tobacco industry as their first invented society for novel tobacco products (heat-not-burn tobacco, hereafter HNB). Since the government set its policy goal to reduce smoking prevalence from 19.5% to 12% by 2022, smoking prevalence was kept steady contrary to the previous downward trend of smoking rates.

Intervention or response:
HNB products were first introduced by Japan Tobacco (JT) in 2015, by Philip Morris International (PMI) in 2016 and finally by British American Tobacco (BAT) in 2017, which obtained remarkable popularity very rapidly. This paper will discuss their risks and impacts to the policy and the society in Japan according to the MPOWER strategies of WHO.

Results and lessons learnt:
Monitor: Government surveys on smoking prevalence do not contain specific questions for HNB and their users consider or misconsider their smoking status how to respond the surveys. PMI recently announced that they obtained potential two million users of IQOS, which counts 10% of smoking population.
Protect: Smokefree legislation is under development except three local ordinance at local levels. National legislation is not prepared but it is hard for the government to restrict HNB products under its legislation.
Offer: Many smokers switch cigarettes to HNB to quit cigarette smoking. At cessation clinics, measurement of carbon monooxide is required but as HNB will not generate CO.
Warn: Tobacco companies are promoting HNB as less harmful products using tricky wording as aerozol or vapor.
Enforcement: Information on HNB is widely distributed. Their appearance on the TV shows and dramas are prominant which induce the equivalent impact as advertisement and promotion.
Raise: HNB products are categorized in Japan as pipe tobacco whose tax rate is relatively lower than cigarettes. So, tax revenue to the goverment is harmed.

Conclusions and key recommendations:
Careful monitoring of HNB is needed and Japan should establish a concrete principle to judge the HNB risks to the society.