Quantifying Population-Level Health Benefits and Harms of E-Cigarette Use in the United States

Soneji SS, Sung HY, Primack BA, Pierce JP, Sargent JD. PLoS One. 2018 Mar 14;13(3):e0193328. [CrossRef] [PubMed]

Electronic cigarettes (e-cigarettes) may help cigarette smokers quit smoking, yet they may also facilitate cigarette smoking for never-smokers. The authors quantified the balance of health benefits and harms associated with e-cigarette use at the population level using a Monte Carlo stochastic simulation model. Model parameters drawn from census counts, national health and tobacco use surveys, and published literature were used to calculate the expected years of life gained or lost from the impact of e-cigarette use on smoking cessation and transition to long-term cigarette smoking among never smokers.  The model estimated that 2,070 additional current cigarette smoking adults would quit smoking and remain continually abstinent from smoking for ≥7 years. However, the model also estimated 168,000 additional never-cigarette smoking adolescents would initiate cigarette smoking and eventually become daily cigarette smokers. Overall, the model estimated that e-cigarette use would lead to 1,510,000 years of life lost. The authors conclude that effective national, state, and local efforts are needed to reduce e-cigarette use among youth and young adults if e-cigarettes are to confer a net population-level benefit in the future.