Declining rates of tobacco use in the Japanese medical profession, 1965-2009

Background: Although there has been a downward trend in smoking rates among medical doctors in recent years, rates have been higher among Japanese doctors when compared internationally. Methods: We extensively reviewed all published English- and Japanese-language articles that reported the smoking rates of Japanese doctors. Results: A total of 36 articles were examined, most of which had been conducted as postal surveys, usually by a national, prefectural, or local medical association. Sample sizes ranged from 17 to 11 773, and response rates ranged from 33% to 91%. National surveys conducted between 1965 and 2009 suggest that there has been a statistically significant (P < 0.0001) decline in smoking rates among Japanese doctors (from around 68% to 16% among males and from 19% to 5% among females). Conclusions: Overall, the published data reveal a significant decline in smoking rates among Japanese doctors since 1965, especially among men. Although less than one-fifth of Japanese male doctors now smoke, more work needs to be done in tobacco control to help further reduce the burden of smoking, especially in medical schools.