Potential deaths averted in USA by replacing cigarettes with e-cigarettes

David T. Levy, Ron Borland, Eric N. Lindblom, Maciej L. Goniewicz, Rafael Meza, Theodore R. Holford, Zhe Yuan, Yuying Luo, Richard J. O’Connor, Raymond Niaura, David Abrams

Research output: Contribution to journalArticle

Abstract

Introduction US tobacco control policies to reduce cigarette use have been effective, but their impact has been relatively slow. This study considers a strategy of switching cigarette smokers to e-cigarette use (’vaping’) in the USA to accelerate tobacco control progress. Methods A Status Quo Scenario, developed to project smoking rates and health outcomes in the absence of vaping, is compared with Substitution models, whereby cigarette use is largely replaced by vaping over a 10-year period. We test an Optimistic and a Pessimistic Scenario, differing in terms of the relative harms of e-cigarettes compared with cigarettes and the impact on overall initiation, cessation and switching. Projected mortality outcomes by age and sex under the Status Quo and E-Cigarette Substitution Scenarios are compared from 2016 to 2100 to determine public health impacts. Findings Compared with the Status Quo, replacement of cigarette by e-cigarette use over a 10-year period yields 6.6 million fewer premature deaths with 86.7 million fewer life years lost in the Optimistic Scenario. Under the Pessimistic Scenario, 1.6 million premature deaths are averted with 20.8 million fewer life years lost. The largest gains are among younger cohorts, with a 0.5 gain in average life expectancy projected for the age 15 years cohort in 2016. Conclusions The tobacco control community has been divided regarding the role of e-cigarettes in tobacco control. Our projections show that a strategy of replacing cigarette smoking with vaping would yield substantial life year gains, even under pessimistic assumptions regarding cessation, initiation and relative harm.

Original languageEnglish (US)
Pages (from-to)18-25
Number of pages8
JournalTobacco Control
Volume27
Issue number1
DOIs
StatePublished - Jan 1 2018

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Tobacco Products
nicotine
scenario
death
Tobacco
substitution
smoking
Premature Mortality
life expectancy
projection
Smoking
mortality
public health
Life Expectancy
health
community
Public Health
Mortality
Vaping
Health

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health

Cite this

Levy, D. T., Borland, R., Lindblom, E. N., Goniewicz, M. L., Meza, R., Holford, T. R., ... Abrams, D. (2018). Potential deaths averted in USA by replacing cigarettes with e-cigarettes. Tobacco Control, 27(1), 18-25. https://doi.org/10.1136/tobaccocontrol-2017-053759

Potential deaths averted in USA by replacing cigarettes with e-cigarettes. / Levy, David T.; Borland, Ron; Lindblom, Eric N.; Goniewicz, Maciej L.; Meza, Rafael; Holford, Theodore R.; Yuan, Zhe; Luo, Yuying; O’Connor, Richard J.; Niaura, Raymond; Abrams, David.

In: Tobacco Control, Vol. 27, No. 1, 01.01.2018, p. 18-25.

Research output: Contribution to journalArticle

Levy, DT, Borland, R, Lindblom, EN, Goniewicz, ML, Meza, R, Holford, TR, Yuan, Z, Luo, Y, O’Connor, RJ, Niaura, R & Abrams, D 2018, 'Potential deaths averted in USA by replacing cigarettes with e-cigarettes', Tobacco Control, vol. 27, no. 1, pp. 18-25. https://doi.org/10.1136/tobaccocontrol-2017-053759
Levy DT, Borland R, Lindblom EN, Goniewicz ML, Meza R, Holford TR et al. Potential deaths averted in USA by replacing cigarettes with e-cigarettes. Tobacco Control. 2018 Jan 1;27(1):18-25. https://doi.org/10.1136/tobaccocontrol-2017-053759
Levy, David T. ; Borland, Ron ; Lindblom, Eric N. ; Goniewicz, Maciej L. ; Meza, Rafael ; Holford, Theodore R. ; Yuan, Zhe ; Luo, Yuying ; O’Connor, Richard J. ; Niaura, Raymond ; Abrams, David. / Potential deaths averted in USA by replacing cigarettes with e-cigarettes. In: Tobacco Control. 2018 ; Vol. 27, No. 1. pp. 18-25.
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