A Magic Bullet? The Potential Impact of E-cigarettes on the Toll of Cigarette Smoking.
Thursday, April 15, 2021
Posted by: Natalia Gromov
David
Mendez, Kenneth E Warner.
A Magic Bullet? The
Potential Impact of E-cigarettes on the Toll of Cigarette Smoking.
Nicotine & Tobacco Research, Volume 23, Issue 4, April 2021, Pages 654–661,
https://doi.org/10.1093/ntr/ntaa160
Introduction. We
examine the proportion of US smoking-produced mortality that e-cigarettes might
eliminate under assumptions regarding vaping’s ability to increase smoking
cessation, vaping’s health risks, and the possibility that vaping will increase
smoking among young people.
Methods. We
employ a dynamic population simulation model that tracks individuals from ages
0 to 110, differentiated by gender and smoking status. Using data from the US
Census, the National Vital Statistics Reports, Cancer Prevention Study II, and
the National Health Interview Survey, we estimate the number of smoking-related
life-years lost (LYL) from 2018 to 2100 in a no-vaping scenario. We then
compare results for model runs that assess the impact of vaping under a variety
of assumptions.
Results. The
combination of assumptions produces 360 possible scenarios. 357 (99%) yield
positive estimates of life-years saved (LYS) due to vaping by 2100, from 143
000 to 65 million. Most scenarios result in millions of individuals quitting
smoking due to vaping. On average, vaping-induced quitters gain an extra
1.2–2.0 years of life compared to smokers who quit without vaping. The impact
of vaping is greatest when it most helps smokers who otherwise have the
greatest difficulty quitting smoking. While the numbers of LYS are generally
large across all scenarios, they often represent a small fraction of the toll
of smoking.
Conclusions. Vaping
is highly likely to reduce smoking-produced mortality. Still, vaping is not
“the” answer to the public health crisis created by smoking. Rather, it may
well be a tool to add to the armamentarium of effective tobacco control
measures.
Implications. E-cigarettes
hold the potential to reduce cigarette smoking’s enormous toll. By itself,
however, tobacco harm reduction, as embodied in vaping, is no magic bullet.
Going forward, tobacco control will require vigilant application of the
evidence-based measures that have brought us so much success in combatting
smoking. It will require, as well, the search for and adoption of novel means
of attacking the remaining problem. Harm reduction can, and many would say
should, be a part of the complex formula that will eventually bring about the
demise of smoking.
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