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Smoking (and smokeless tobacco products) is a major risk factor for developing gum disease (periodontitis) and also impacts the response to treatment for gum disease

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(2) Applicable threshold

Meanwhile 11.8% of Japanese adults were current users of HTP in 2025, which amounted to 12.9 million people.[19] In contrast, only 2.1 million people in Japan were currently using nicotine vapes in 2025.[20] This is still a significant number of people, but is six times lower than the figure for HTP users, primarily due to the fact that vapes are banned (unless licensed as a medicinal product), while HTP can be legally bought online and in-store