Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 3;18(9):4876.
doi: 10.3390/ijerph18094876.

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

David T Levy  1 , Luz María Sánchez-Romero  1 , Nargiz Travis  1 , Zhe Yuan  1 , Yameng Li  1 , Sarah Skolnick  2 , Jihyoun Jeon  2 , Jamie Tam  3 , Rafael Meza  2
Affiliations

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

David T Levy et al. Int J Environ Res Public Health. .

Abstract

The public health impact of nicotine vaping products (NVPs) is subject to a complex set of uncertain transitions between NVP and cigarette use. Instead, we apply an indirect method to gauge the impact of NVP use on smoking prevalence and smoking-attributable deaths (SADs) using the well-established SimSmoke tobacco control policy simulation model. Upon validating the model before NVPs were more widely used, we project a No-NVP (i.e., in the absence of NVPs) while controlling for the impact of cigarette-oriented policies. The net impact of NVPs on smoking prevalence is inferred by comparing the projected No-NVP smoking trends to corresponding trends from two US national surveys. Using the TUS-CPS estimates for the period 2012-2018, we estimate that adult smoking prevalence declined in relative terms by 9.7% (95% CI: 7.5-11.7%) for males and 10.7% (95% CI: 9.1-13.0%) for females. Compared to NHIS, smoking prevalence declined by 10.7% (95% CI: 6.8-14.6%) for males and 11.3% (95% CI: 7.4-15.6%) for females. These impacts were confined mainly to ages 18-44. Vaping-related reductions in smoking prevalence were projected to avert nearly 0.4 million SADs between 2012 and 2052. Our analysis indicates that NVP use is associated with substantial reductions in US smoking prevalence among younger adults.

Keywords: ENDS; cigarettes; e-cigarettes; public health; simulation model; smoking; tobacco control; vaping.

PubMed Disclaimer

Conflict of interest statement

All authors declare that they have no competing interest.

Figures

Figure 1
Figure 1
Smoking prevalence in surveys and the SimSmoke model with/without the NVP adjustors by sex, ages 18 and above, 1993–2018.
See this image and copyright information in PMC

References

    1. U.S. Department of Health and Human Services . The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Editor; Atlanta, GA, USA: 2014.
    1. Holford T.R., Meza R., Warner K.E., Meernik C., Jeon J., Moolgavkar S.H., Levy D.T. Tobacco control and the reduction in smoking-related premature deaths in the United States, 1964–2012. JAMA. 2014;311:164–171. doi: 10.1001/jama.2013.285112. - DOI - PMC - PubMed
    1. Levy D.T., Meza R., Zhang Y., Holford T.R. Gauging the Effect of U.S. Tobacco Control Policies from 1965 through 2014 Using SimSmoke. Am. J. Prev. Med. 2016;50:535–542. doi: 10.1016/j.amepre.2015.10.001. - DOI - PMC - PubMed
    1. Warner K.E. Tobacco control policies and their impacts. Past, present, and future. Ann. Am. Thorac. Soc. 2014;11:227–230. doi: 10.1513/AnnalsATS.201307-244PS. - DOI - PubMed
    1. Levy D.T., Meza R., Zhang Y., Holford T.R. Impact of tobacco control on adult per capita cigarette consumption in the United States. Am. J. Public Health. 2014;104:83–89. - PMC - PubMed

Publication types