Cigarette smoking continues its rapid decline in Japan while the upward trajectory of smokers seeking alternative nicotine products shows no signs of slowing down. According to PMI a small percentage (calculated variously at between 5—15%) of their IQOS customers are dual users, but the rest have fully converted. The access to the market for companies like PMI afforded by the Japanese government plays a big part in this; advertising is seemingly allowed in any ways the imagination can conceive and is just as ubiquitous as the most aggressive cigarette advertising. Tobacco regulators around the world may choke on the vapour here, but the experience in Japan strongly suggests that putting obstacles in the way of e-cigarette and HNB marketing simply prolongs your cigarette problem.

Significant progress has been made in reducing smoking prevalence within the United Kingdom but the benefits have not fallen fairly across all groups. Smoking rates amongst those with personal incomes under £10,000 per annum is more than double of those with incomes over £40,000. However, there are other groups with rates higher still, for example people experiencing mental ill health have a smoking prevalence rate double the population average. Amongst those who are homeless or rough sleeping we see even higher rates, in many instances services report that all their clients smoke.