Switching to e-cigarettes could save the lives of half a million Australian smokers

Posted by DrMendelsohn on 3 October, 2017

Up to 6.6 million early deaths in America might be averted and 86.7 million fewer life years lost if most smokers switched to e-cigarettes over the nexxt 10 years, according to an analysis published yesterday. In Australia this would mean the prevention of about 500,000 smoking-related deaths.

The study published in Tobacco Control calculated worst and best case scenarios for public health outcomes in the United States if cigarette smoking was partly replaced by e-cigarettes.

The best case scenario was based on the current known estimates of the risks and benefits of vaping

  • the effectiveness of ecigs as a quitting aid
  • the health risk of vaping (about 5% of the risk of smoking)
  • the known risks from uptake by non-smokers
  • dual use

It assumed that most smokers would switch to vaping, leaving a residual 5% smoking prevalence. After weighing up the benefits and risk, the overall long-term positive net effect to public health was substantial.

A worst case analysis was also presented in which vaping was assumed to be much more harmful than the science currently suggests (40% as harmful as smoking), uptake by non-smokers was much higher than currently and that e-cigarette were 50% less effective for quitting than is currently seen, leaving a 10% residual smoking rate.

This worst case scenario still produces a substantial public health benefit, preventing 1.6 million premature deaths and averting 20.8 million fewer life years lost.

A further benefits would also occur from reduced secondhand smoke.

The overall conclusion from the study was that:

'a hypothetical substitution of e-cigarette for cigarette use provides tremendous potential to avert premature deaths due to smoking, with only a relatively small amount of premature deaths due to e-cigarettes'

Even the worst case scenario which made the pessimistic assumptions above produced substantial overall net health gains.

Some experts not directly involved in the research also said its findings held a clear message. Professor John Britton, director of the UK Centre for Tobacco and Alcohol Studies at Nottingham University.

“The benefits are massive and demonstrate the importance of embracing, rather than rejecting, the potential of this new generation of nicotine products,”

The findings replicated other modelling studies that have previously been published (McRobbie 2016, Cherng 2016, Hill 2017) that have shown that even after accounting for the potential risks from e-cigarettes, the net public health benefits are substantial.

The best results to public health will occur if e-cigarettes are available as a complementary strategy to traditional tobacco control strategies. Smoking rates in Australia have stalled over the last 3 years and we need to incorporate tobacco harm reduction strategies to accelerate progress.


Levy DT et al. Potential deaths averted in USA by replacing cigarettes with e-cigarettes. Tobacco Control 2017

Reuters Media release: Switching to e-cigarettes could save 6.6 million American smokers: researchers


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