Healthcare Utilization and Expenditures Attributable to Current E-cigarette Use among US Adults.
Thursday, June 16, 2022
Wang
Y, Sung H, Lightwood J, et al.
Healthcare Utilization and
Expenditures Attributable to Current E-cigarette Use among US Adults.
Tobacco Control Published Online First: 23 May 2022. doi:
10.1136/tobaccocontrol-2021-057058
Aims. This
study estimated annual healthcare expenditures attributable to current
e-cigarette use among US adults, including current exclusive and dual/poly
e-cigarette use.
Methods. Analysing
the 2015–2018 National Health Interview Survey data, we estimated the impacts
of e-cigarette use on healthcare utilisation among adults aged 18+ years.
Healthcare utilisation outcomes were hospital nights, emergency room (ER)
visits, doctor visits and home visits. Current e-cigarette use was categorised
as exclusive and dual/poly e-cigarette use. The econometric model included two
equations: health status as a function of e-cigarette use and other independent
variables, and healthcare utilisation as a function of health status,
e-cigarette use, and other independent variables. Using an ‘excess utilisation’
approach, we multiplied the e-cigarette-attributable fraction derived from the
model by annual health expenditures to calculate healthcare expenditures
attributable to current exclusive and dual/poly e-cigarette use, the sum of
which were expenditures attributable to all current e-cigarette use.
Results. Current
exclusive and dual/poly e-cigarette use, with 0.2% and 3.5% prevalence in
2015–2018, were associated with higher odds of reporting poor health status
than never tobacco users. Poor health status was associated with higher odds of
using the four healthcare services and a greater number of ER and doctor
visits. Annual healthcare expenditures attributable to all current e-cigarette
use was $15.1 billion ($2024 per user) in 2018, including $1.3 billion
attributable to exclusive e-cigarette use ($1796 per user) and $13.8 billion
attributable to dual/poly e-cigarette use ($2050 per user).
Conclusion. Adult
current e-cigarette use was associated with substantial excess healthcare
utilisation and expenditures.
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