{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:58:37Z","timestamp":1785776317221,"version":"3.56.0"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005769","name":"National Institute for Environmental Studies","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005769","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Physical inactivity contributes to adverse health outcomes and is particularly detrimental in respiratory diseases. Despite being promoted as safer cigarette alternatives, the behavioural effects of heated tobacco products (HTPs) on physical activity remain unclear. This study examined the association between HTP use and physical activity among Japanese adults, particularly those with respiratory diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional study used data from the 2023 Japan COVID\u201019 and Society Internet Survey (JACSIS), including 28,353 participants aged \u2265\u200915\u2009years. Tobacco use was classified as never, current, or former use of cigarettes and\/or HTPs. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) and expressed in MET\u2010min\/week. Multivariable analyses applied analysis of covariance (ANCOVA) and logistic regression comparing low versus moderate\/high physical activity, adjusting for demographic, behavioural, and health factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Predicted means of physical activity from the ANCOVA model were 1100.9 for never smokers, 1006.8 for cigarette smokers, and 945.6 MET\u2010min\/week for HTP users. Current cigarette smokers (\u03b2\u2009=\u2009\u221294.1 [95% CI: \u2212176.7 to \u221211.5],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026) and current HTP users (\u03b2\u2009=\u2009\u2212155.3 [95% CI: \u2212252.7 to \u221257.9],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) exhibited significantly lower physical activity than never smokers. Sensitivity analyses using log\u2010transformed IPAQ scores and logistic regression confirmed these findings. Subgroup analyses indicated reduced activity among HTP users with asthma, but no clear pattern for COPD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Cigarette smoking and HTP use were associated with lower physical activity, independent of confounders. Smoking cessation, particularly in asthma, should be prioritized, alongside promoting physical activity among tobacco users.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70256-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/resp.70256","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T06:10:10Z","timestamp":1777011010000},"page":"819-829","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heated Tobacco Product Use and Lower Physical Activity Among Japanese Adults With and Without Respiratory Diseases: Findings From the\n                    <scp>JACSIS<\/scp>\n                    Study"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4817-2210","authenticated-orcid":false,"given":"Mitsuo","family":"Hashimoto","sequence":"first","affiliation":[{"name":"Faculty of Sport Science, Department of Health Science Nippon Sport Science University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7781-7544","authenticated-orcid":false,"given":"Hiroki","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Data Seed Inc.  Tokyo Japan"},{"name":"Department of Public Health, Graduate School of Medicine Hokkaido University  Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Tabuchi","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, School of Public Health Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-103640"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-018-0659-8"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-2521"},{"key":"e_1_2_11_6_1","article-title":"A Comprehensive Review on the Impacts of Smoking on the Health of an Individual","volume":"15","author":"Varghese J.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1265\/ehpm.22-00219"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2020-055652"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2017-054216"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-016-0481-x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.12974\/2312-5470.2021.07.05"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-032852"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-017-0967-3"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.5993\/AJHB.32.1.9"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/21642850.2022.2037429"},{"key":"e_1_2_11_16_1","unstructured":"Ministry of Health Labour and Welfare \u201cNational Health and Nutrition Survey Table\u00a015: Mean and Standard Deviation of BMI by Age Group Sex (Aged 15\u2009Years and Over Excluding Pregnant Women)\u201d(2022) accessed: 2025\u201009\u201028 https:\/\/www.e\u2010stat.go.jp\/dbview?sid=0003224178."},{"key":"e_1_2_11_17_1","unstructured":"IPAQ Research Committee \u201cGuidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ)\u2014Short and Long Forms\u201d(2005) https:\/\/biobank.ndph.ox.ac.uk\/showcase\/ukb\/docs\/ipaq_analysis.pdf."},{"key":"e_1_2_11_18_1","first-page":"1","article-title":"Validity and Reliability of Japanese Version of International Physical Activity Questionnaire","volume":"49","author":"Murase N.","year":"2002","journal-title":"Journal of Health and Welfare Statistics"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.5455\/njppp.2017.7.0825604092016"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5857-z"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.12466"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/1348-9585.12411"},{"key":"e_1_2_11_23_1","unstructured":"Ministry of Health Labour and Welfare \u201cResults of the 2023 Comprehensive Survey of Living Conditions: Household Income Distribution (in Japanese)\u201d(2024) accessed: 2025 October 3 https:\/\/www.mhlw.go.jp\/toukei\/saikin\/hw\/k\u2010tyosa\/k\u2010tyosa23\/dl\/04.pdf."},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2024.111315"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s44167-024-00067-3"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-204763"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-7435(03)00179-8"},{"key":"e_1_2_11_29_1","unstructured":"Centers for Disease Control and Prevention \u201cMeasuring Healthy Days: Population Assessment of Health\u2010Related Quality of Life (HRQOL). 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