An integrated SWOT-AHP strategic positioning framework for assessing sustainable forest wellness tourism development in mountain regions.

The global wellness tourism sector reached an estimated $639 billion in 2023, with projected annual growth rates of 16.6% through 2030, substantially exceeding conventional tourism growth of approximately 5.8%. This expansion reflects fundamental societal shifts, including intensifying urbanisation pressures, escalating chronic disease burdens—with non-communicable diseases accounting for 71% of global deaths—and growing health consciousness among populations with rising disposable incomes. Within this broader wellness tourism ecosystem, forest wellness tourism has emerged as a distinctive paradigm that deliberately leverages forest ecosystem services to promote holistic health outcomes encompassing physiological, psychological, and social dimensions. The conceptual origins of forest wellness tourism are most commonly traced to the Japanese practice of shinrin-yoku (forest bathing), developed in the 1980s as a form of preventive health intervention integrating traditional nature-based healing with contemporary medicine. A substantial body of clinical research has since established measurable health benefits associated with forest exposure. Park et al. demonstrated that forest environments produced significant reductions in salivary cortisol (13.4%), systolic blood pressure (1.9%), and pulse rate (6.0%) across 24 experimental sites in Japan. Li et al. established that forest exposure enhances natural killer (NK) cell activity—a key component of innate immune defence—with effects persisting up to 30 days post-exposure. Meta-analytical synthesis by Kotera, Richardson, and Sheffield, aggregating 28 controlled studies (n = 2725), confirmed moderate-to-large effect sizes for anxiety reduction (Cohen’s d = 0.61), depression alleviation (d = 0.54), and mood improvement (d = 0.71). More recent post-pandemic studies have documented heightened mental health benefits of forest-based interventions, particularly among populations experiencing prolonged urban confinement. The development of forest wellness tourism as an organised sector varies considerably across national contexts, offering instructive comparisons for emerging programmes. South Korea established a national Forest Therapy programme in 2012 under the Korea Forest Service, which by 2023 operated over 40 designated healing forests and trained more than 1000 certified forest therapy instructors; clinical evaluations have documented significant reductions in stress biomarkers and improvements in mood states among participants. In Central Europe, Germany has a century-long tradition of Kurwald (healing forest) designations linked to the Kneipp hydrotherapy tradition, with certified therapeutic forests integrated into health insurance reimbursement systems in several regions. Finland has adopted nature-based wellness as a strategic tourism differentiation tool, leveraging extensive boreal forests (73% land coverage) and a well-established research infrastructure connecting forest exposure to stress recovery and attention restoration. These international experiences share common themes—the importance of scientific evidence to underpin health claims, the role of institutional frameworks in standardising service quality, and the challenge of balancing visitor access with ecological integrity—that are directly relevant to emerging programmes in China.