A modeling approach to gauging the effects of nicotine vaping product use on cessation from cigarettes: what do we know, what do we need to know?

Abstract

Background and aims The long-term population health impact of nicotine vaping products (NVPs) use among smokers is unknown, and subject to a range of plausible assumptions about the use and health consequences of NVPs. While NVPs use may substitute for cigarette smoking and thereby aid in quitting cigarette use, it is also possible that smokers who would have otherwise quit would instead delay quitting cigarettes. We aimed to develop a cohort-specific simulation model of the impact of NVPs on smoking cessation by adult smokers and resulting premature deaths (PD) and life years lost (LYL). Design A cohort-specific simulation model of the impact of NVPs on smoking cessation by adult smokers and resulting premature deaths (PD) and life years lost (LYL) was developed by gender for two birth cohorts, aged 30 and 50 years in 2012. Extensive sensitivity analyses were conducted. Setting United States. Participants Smokers in two birth cohorts, aged 30 and 50 years in 2012. Measurements Data were from the 1965-2012 National Health Interview Surveys and the 2014/15 Tobacco Use Supplement of the Current Population Survey. The model incorporated a range of plausible assumptions from published literature about transition rates from regular smoking to exclusive NVP and dualuse, from dual use to exclusive NVP use and from exclusive NVP use to no use. Findings Compared with the no-NVP scenario, the male (female) model projected 17.8% (19.3%) fewer PDs and 22.9% (26.6%) fewer LYL for the 1982 cohort and 5.4% (7.3%) fewer PDs and 7.9% (11.4%) fewer LYL for the 1962 cohort. These gains were sensitive to NVP use over time, age of initial NVP use, transitions from smoking to dual, exclusive NVP and no use and relative NVP mortality risks.Conclusions Nicotine vaping product (NVP) use in the United States is projected to have a net positive impact on population health over a wide range of plausible levels of NVP use, transitions to dual, exclusive NVP and no use and NVP risks. However, net impact is sensitive to parameter estimates.

US Nicotine Vaping Product SimSmoke Simulation Model: The Effect of Vaping and Tobacco Control Policies on Smoking Prevalence and Smoking-Attributable Deaths

“…Over the period 2012–2018, the implied NVP-related reductions in smoking prevalence were estimated at 10–11% for male and female adults ages 18 and above, with reductions ranging from 43 to 53% for ages 18–24 and 11 to 20% for ages 25–44. The results for young adults are broadly consistent with other modeling studies [ 69 , 70 ], and empirical studies that show higher NVP use in this age group [ 62 , 64 , 65 , 71 , 72 ] and related reductions in smoking prevalence [ 19 , 23 , 26 , 73 , 74 , 75 , 76 , 77 ]. At older ages, the estimates often implied NVP-related increases in smoking (e.g., through reduced cessation or increased relapse [ 28 , 29 ]), but SimSmoke estimates were generally within CIs of survey estimates thus suggesting no differences.…”

Diversifizierung der Rauchentwöhnungsprogramme – die Rolle der E-Zigarette

“…Die Ergebnisse von Eisenberg et al [32] werden durch Levy et al [33] mithilfe einer Modellierung auf Basis von US-Gesundheitsdaten unterstützt, auch wenn die Grundannahmen der Modellierung durchaus optimistisch gewählt sind. Den Ergebnissen dieser Studie zufolge zeigt sich, dass der verstärkte Einsatz von E-Zigaretten und anderen neuartigen Nikotinprodukten im Public-Health-Kontext einen signifikanten positiven Effekt auf die Raucherzahlen und die gesundheitlichen Folgen, die mit dem Rauchen assoziiert sind, haben kann.…”

E-Cigarette Markets and Policy Responses in Southeast Asia: A Scoping Review

“…2 E-cigarettes remain controversial as the evidence base remains inconclusive on their long-term safety and effectiveness as a smoking cessation aid. Among recent studies published between 2018 and 2020, e-cigarettes were found to aid smoking cessation in some studies [3][4][5][6][7][8][9][10][11] and hinder smoking cessation in others, [12][13][14][15][16] while other studies were inconclusive. While some studies are inconclusive on the long-term health impacts of vaping, [42][43][44][45][46][47][48][49] others suggest that it may cause cardiovascular [50][51][52][53][54][55] or respiratory [56][57][58][59][60][61] diseases.…”