Although nicotine substitution in the form of nicotine gum (“Nicorette”) or delivery through the skin (“the patch”) has been widely accepted as a strategy for tobacco abatement and cessation, opinion has been sharply divided regarding the harms versus benefits of e-cigarettes (“vaping”).
A recent report in the British Medical Journal – Tobacco Control examined the potential benefits of vaping on mortality in the US. The authors projected smoking rates and health outcomes in the absence of vaping, to those where cigarette use was replaced by vaping over a 10-year period. The investigators ran their projection under two sets of assumptions – an Optimistic Scenario based upon current use patterns of e-cigarettes and published estimates of harm reduction due to vaping, and a Pessimistic Scenario based upon an increase in the number of people vaping, and with e-cigarettes more harmful than evidence suggests. Mortality by age and sex were projected and compared from 2016 to 2100 to determine the public health impact. Compared with the status quo, under the Optimistic Scenario we could expect to see 6.6 million fewer premature deaths, with 86.7 million fewer life years lost, and even with the Pessimistic Scenario, we would expect to see 1.6 million fewer premature deaths, with 20.8 million fewer life years lost. Young people saw the most benefit.
The authors concluded that substitution of e-cigarettes for cigarette use provides a tremendous potential to avert premature deaths due to smoking, even under pessimistic assumptions.