Alcohol, smoking, and obesity epidemiology in Japan.

The health impact of alcohol drinking, cigarette smoking and obesity differs between Asian and Western countries. The epidemiology of cancer and death related to these lifestyles are described in this article. In Japan, heavy alcohol drinking and cigarette smoking are rather high in men. While there is a worldwide anti-smoking policy, Japan is still on the way to aiming at this goal, and this delay in health promotion has maintained the high impact of smoking, whether active or passive, on people's health in that country. Public health policy should focus more strongly on the control of smoking and heavy drinking, especially among men. Maintaining the consumption of alcohol at a level below 46 g a day in men and 23 g a day in women appears to minimize the risks of mortality and cancer in the Japanese population. On the other hand, the obesity rate is low and being underweight is common both in men and women. Proportions of cancer attributable to a body mass index of 25 or more are only 0.5% in men and 1.1% in women. Given that many previous studies in Japanese and Asian populations have associated a low body mass index with an increased risk of cancer, the impact of being underweight--not only obese--may warrant further investigation.