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Model suggests e-cigarette use could reduce smoking-related mortality
The use of vaporized nicotine products, such as e-cigarettes, projected a reduction in the number of smoking-related deaths by 21% when compared with a scenario without e-cigarettes in which smokers used traditional tobacco products, according to a modeling study.
“If used instead of smoking cigarettes, [vaporized nicotine products (VNPs)] provide the potential to reduce harm and thereby improve population health,” David T. Levy, PhD, professor of oncology at Georgetown University, and colleagues wrote. “However, VNPs have the potential to increase population-level harm if youth who would not have otherwise smoked become cigarette smokers as a direct consequence of using VNPs or if current smokers who would otherwise have quit smoking cigarettes instead delay or fail to quit.”
Levy and colleagues examined a cohort of people, aged 15 years in 2012, to estimate how the impact of VNP would alter smoking patterns among people who otherwise would have smoked cigarettes, and among those who would not have otherwise smoked cigarettes without the availability of VNPs.
The model exhibited the decisions regarding VNP use individuals made at each age and compared that use to a no-VNP use scenario established on an age-period-cohort analysis. The model also included transitions from trial to established VNP use, transitions to exclusive VNP and dual use, and the effects of stopping at later ages. The investigators then projected the impact of deaths and life years lost on public health on the study cohort, including evidence-informed parameter estimates.
Compared with a scenario without VNPs, Levy and colleagues projected a 21% reduction in smoking-attributable deaths and a 20% decline in life years lost as a result of VNP use. Their projection was based on current use patterns and conservative assumptions. Health gains from VNP use, researchers found in the sensitivity analysis, were particularly sensitive to VNP risks and use rates of VNP among those likely to smoke cigarettes.
“Our analysis suggests the likelihood of public health gains due to VNP use at early ages under most plausible scenarios, and sensitivity analysis provides an indication of tipping points where harms will exceed benefits,” Levy and colleagues wrote. “Better information is needed for proven measures of trial and established use and on the long-term trajectories of those who try VNPs in terms of whether they would have otherwise initiated or continued to smoke.” – by Savannah Demko
Disclosure: Levy reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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