Healthcare costs attributable to e-cigarette use and subsequent uptake of cigarette smoking by Australians who have never smoked

• Published in: Australian health review 2024-02, Vol.48 (1), p.52-57
• Main Authors: Gordon, Louisa G., Preston, Paige
• Format: Article
• Language: English
• Subjects: Chemicals; Chronic illnesses; Costs; Disease; Electronic cigarettes; Health care expenditures; Legislation; Nicotine; Poisoning; Poisons; Public health; Smoking cessation; Tobacco; Toxicity; Trends; Vaping; Womens health
• ISSN: 0156-5788; 1449-8944
• DOI: 10.1071/AH23178

Objective. New legislation to curb the rapid increase in e-cigarette use among youth is underway. We estimated the future healthcare costs for chronic diseases from e-cigarette use among never smokers who transition to tobacco smoking. Methods. Using populationattributable fractions, we estimated the health expenditure attributable to e-cigarettes based on the prevalence of e-cigarette use, uptake of tobacco smoking, and risk of smoking on developing chronic disease. Data for men and women were derived from published reports on e-cigarette use prevalence, risk of smoking-related disease and addiction, and health expenditure for 25 diseases. Sensitivity analyses were undertaken to address data input variation. Results. Future healthcare costs attributed to new e-cigarette-initiated smokers were conservatively estimated to be (in Australian dollars) $179.6 million annually. Collectively, the estimated costs were highest for respiratory diseases ($102.2 million; 57% of total costs), malignant cancers ($49.6 million; 28%), and cardiovascular disease ($27.7 million; 15%). The uptake rate of e-cigarettes was more important in driving healthcare costs than the proportion moving from e-cigarettes to cigarette smoking. Conclusion. High avoidable health system costs are predicted for the treatment of chronic conditions created by e-cigarette-initiated smoking. These costs exclude the immediate and direct healthcare harms of e-cigarette-related poisoning, lung injury, and respiratory problems, and costs associated with the unknown health harms of e-cigarette use alone. The proposed regulations to curb recreational e-cigarette use in Australia are set to prevent expensive health care arising sometime in the future from new cigarette smokers.