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Why do Japanese Men Have Less Lung Cancer Even Though They Smoke More?


Updated August 07, 2014

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Question: Why do Japanese Men Have Less Lung Cancer Even Though They Smoke More?


The lower incidence of lung cancer in Japan, despite a higher smoking rate than the United States, is known as the “Japanese smoking lung cancer paradox.” The debate is not about smoking, since we know that smoking causes lung cancer. The debate is about why Japanese smokers have a lower incidence of lung cancer, even though they smoke more. The answer is most likely a combination of reasons that include:

  • Lower alcohol consumption by Japanese males
  • Lower fat intake by Japanese males
  • Higher efficiency of filters in Japanese cigarettes
  • Lower levels of carcinogens in Japanese cigarettes
  • Genetic factors that result in Japanese men being less prone to developing lung cancer
  • Earlier age of smoking onset in American men
  • Lifestyle factors other than smoking, such as diet and exercise

Certainly, genetic factors are beyond our control, but American men who wish to lower their risk of lung cancer may want to consider limiting their alcohol intake and consumption of high-fat foods.

Further Reading:


Marugame, T. et al. Lung cancer death rates by smoking status: comparison of the Three-Prefecture Cohort Study in Japan to the Cancer Prevention Study II in the USA. Cancer Science. 2005. 96(2):120-6.

Stellman, S. et al. Smoking and lung cancer risk in American and Japanese men: an international case-control study. Cancer Epidemiology Biomarkers and Prevention. 2001. 10(11):1193-9.

Takahashi, I. et al. Differences in the influence of tobacco smoking on lung cancer between Japan and the USA: possible explanations for the ‘smoking paradox’ in Japan. Public Health. 2008. April 15 (Epub ahead of time).

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