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How E-Cigarettes Could Do More Good Than Harm

Do e-cigarettes help or hinder public health? One mathematical model offers a very preliminary answer.

By Francie Diep


(Photo: Christopher Furlong/Getty Images)

Some good news for vaping advocates: E-cigarettes will prevent more American deaths from smoking-related diseases than they’ll cause, according to a new study.

“The evidence to date is suggestive that e-cigarettes are more likely to provide public health benefits than harms,” says Georgetown University economist David Levy, lead author on the study. Levy’s conclusion is sure to be controversial — and one that’s subject to serious caveats even Levy admits to— but it brings up interesting questions about whether e-cigarettes have some benefits, and, if they do, how to maximize them.

There’s a hot debate going on right now about whether e-cigarettes help or hinder public health. Both smoking and vaping expose you to harmful chemicals, but some argue that if people are going to smoke something nicotine-filled, it’s better they use e-cigs. Others counter that e-cigarettes’ health consequences will turn out to be more dire than we currently think.

The model found that the existence of e-cigarettes means fewer Americans will die because of smoking-related cancer, heart disease, and other illnesses.

Determining the true overall effects of e-cigarettes relies on many hypotheticals. If e-cigarettes didn’t exist, who would have used tobacco products instead, and how often? How many people who are now vaping never would have become addicted to nicotine otherwise? And just how bad are e-cigarettes for you in the first place?

To answer some of these questions, Levy gathered a team of researchers from the United States, Australia, and Canada to run a mathematical model based on their own “guesstimates” — Levy’s word — about these hypotheticals. It crunches the numbers to figure out how many Americans would die of cancer in two possible futures: one based on a world where e-cigarettes didn’t exist, and one based on the researchers’ guesstimates.

The model found that the existence of e-cigarettes means fewer Americans will die because of smoking-related cancer, heart disease, and other illnesses. One major reason: There’s evidence that many e-cigarette users already smoke and that they may replace some or all of their regular smoking with vaping, which is almost certainly less harmful (although to what degree remains to be seen).

Yet even Levy admits the model isn’t a precise prediction of the future. The estimates his team used for their alternate futures are still too uncertain. Instead, Levy says, the team wanted to highlight the data that’s still missing, and to reinforce the notion that regular smoking is America’s biggest nicotine-related health threat.

“We should not over-regulate in the sense that we discourage innovations in e-cigarettes and producing e-cigarettes that are good replacements for cigarettes,” Levy says—products that are less harmful than combustible tobacco, that combustible tobacco-smokers are happy to use instead, when they are unable to quit.