This study aims to estimate the prevalence and dual use of cigarettes, heated tobacco products (HTPs) and electronic cigarettes (e-cigarettes) among individuals aged 18–24 in Japan.

This cross-sectional study involved a door-to-door survey administered by trained interviewers using a structured questionnaire.

Individuals aged 18–24 residing in 220 areas within 10 ordinance-designated cities (Sapporo, Sendai, Saitama, Chiba, Yokohama, Kawasaki, Sagamihara, Nagoya, Osaka and Fukuoka) as well as Tokyo’s 23 wards in Japan in 2019 were included.

A total of 1738/5500 individuals were included in the analysis, with participants evenly distributed by sex, age and residential area.

Cigarette, HTP and e-cigarette use was assessed.

The weighted prevalence of the current use of cigarettes, HTPs and e-cigarettes accounted for 10.1% (95% CI 8.7, 11.5), 5.1% (95% CI 4.1, 6.1) and 1.8% (95% CI 1.2, 2.4), respectively. Approximately 68.2% of the people who used HTPs at the time were dual users of both HTPs and cigarettes. There was a significant gap in tobacco product use between individuals aged 20–24 and those aged 18–19, with this difference remaining after adjusting for covariates.

In 2019, cigarettes were the most used tobacco-related product among young adults in Japan. Smoking initiation appears to notably increase at age 20 when smoking becomes legal in Japan. The prevalence of HTP use among young adults in Japan is notably higher than in other countries.

The prevention of treatment discontinuation is crucial in mitigating the adverse consequences of diabetes. This study aimed to identify the psychosocial factors and patient experiences associated with the discontinuation of diabetes treatment.

A cross-sectional study was conducted.

A nationwide online survey with convenience sampling.

Participants, aged 40–79 years, who reported living with diabetes, were included.

Treatment continuation status was the outcome variable. Participants who previously received regular treatment but were not currently under medical care were classified as the treatment discontinuation group. Psychological factors (mood and anxiety disorders, self-esteem, procrastination), social factors (loneliness, economic difficulties, adverse childhood experiences) and patient experiences and opinions regarding diabetes were assessed.

A total of 4715 individuals were included in the analysis. After adjusting for confounders, psychological distress (adjusted OR (AOR)=1.87, 95% CI (1.06 to 3.30), p=0.032) and higher procrastination (AOR=2.64, 95% CI (1.25 to 5.56), p=0.011) were significantly associated with treatment discontinuation. Overall, 9.7% of participants reported financial hardship, and 12.1% reported diabetes burnout during their course of treatment. Financial hardships (p=0.002), difficulty with child or older adult care (p

Psychological distress and higher procrastination levels were significantly associated with diabetes treatment discontinuation, after adjusting for potential confounders. The treatment discontinuation group reported significantly more psychosocial challenges than the continuation group. Healthcare providers and systems should prioritise addressing the psychosocial characteristics, experiences and challenges faced by individuals with diabetes.