Abstract
BackgroundRecent estimates indicated substantially replacing cigarettes by e-cigarettes would, during 2016–2100, reduce US deaths and life-years lost (millions) by 6.6 and 86.7 (Optimistic Scenario) and 1.6 and 20.8 (Pessimistic). To provide additional insight we use alternative modelling based on a shorter period (1991–2040), four main smoking-associated diseases, deaths aged 30–79 years, and a full product history. We consider variations in: assumed effective dose of e-cigarettes versus cigarettes (F); their relative quitting rate (Q); proportions smoking after 10 years (X); and initiation rate (I) of vaping, relative to smoking.MethodsWe set F = 0.05, X = 5%, Q = 1.0 and I = 1.0 (Main Scenario) and F = 0.4, X = 10%, Q = 0.5 and I = 1.5 (Pessimistic Scenario). Sensitivity Analyses varied Main Scenario parameters singly; F from 0 to 0.4, X 0.01% to 15%, and Q and I 0.5 to 1.5. To allow comparison with prior work, individuals cannot be dual users, re-initiate, or switch except from cigarettes to e-cigarettes.ResultsMain Scenario reductions were 2.52 and 26.23 million deaths and life-years lost; Pessimistic Scenario reductions were 0.76 and 8.31 million. These were less than previously, due to the more limited age-range and follow-up, and restriction to four diseases. Reductions in deaths (millions) varied most for X, from 3.22 (X = 0.01%) to 1.31 (X = 15%), and F, 2.74 (F = 0) to 1.35 (F = 0.4). Varying Q or I had little effect.ConclusionsSubstantial reductions in deaths and life-years lost were observed even under pessimistic assumptions. Estimates varied most for X and F. These findings supplement literature indicating e-cigarettes can importantly impact health challenges from smoking.
Highlights
In 2018, Levy et al (2018) estimated the effects on US mortality that would occur over 2016 to 2100 if e-cigarette use (“vaping”) largely replaced cigarette smoking (“smoking”) over the first 10 years
Online Resource 7 gives the full output from all runs of Population Health Impact Model (PHIM) as well as an explanation of the results
Predicted trends in never and former user prevalence are indistinguishable between the Null and Main Scenarios, whereas the switch from current smoking to current vaping in the Main Scenario is clear (Figures S8.1 and S8.2)
Summary
In 2018, Levy et al (2018) (subsequently referred to as Levy) estimated the effects on US mortality that would occur over 2016 to 2100 if e-cigarette use (“vaping”) largely replaced cigarette smoking (“smoking”) over the first 10 years. Their methodology involved forward projection of smoking rates based on age- and sex-specific initiation and cessation rates using an age-period-cohort model. Recent estimates indicated substantially replacing cigarettes by e-cigarettes would, during 2016–2100, reduce US deaths and life-years lost (millions) by 6.6 and 86.7 (Optimistic Scenario) and 1.6 and 20.8 (Pessimistic). These findings supplement literature indicating e-cigarettes can importantly impact health challenges from smoking
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