The Impact of Electronic Cigarettes on Cigarette Smoking By Americans and Its Health and Economic Implications

Summary of Study

Bottom Line: Cigarette smoking fell significantly between 2013 and 2017 in conjunction with the rise of e-cigarettes. Statistical analysis suggests that about 70 percent of the increased decline in cigarette smoking from 2013 to 2017 was associated with the rising use of e-cigarettes and that e-cigarettes are not a gateway to smoking cigarettes. This suggests that e-cigarettes are an effective tool to help people stop smoking or avoid starting to smoke cigarettes.

The cigarette smoking rate fell from 20.2% to 14.6% between 2014 and 2017, with the rising use of e-cigarettes accounting for 3.3 percentage points of this decline, equating to nearly four million people who otherwise would have smoked.

By reducing cigarette smoking, e-cigarettes also reduce healthcare costs and extend lifespans. Annual per capita healthcare costs of smokers is nearly ten percent greater than non-smokers, suggesting that e-cigarettes reduce lifetime healthcare costs by about $300 billion by stopping people who otherwise would have smoked cigarettes.

E-cigarettes extend the lifespans of more than 330,000 people who otherwise would have died by their mid-to-late 60s if they had started smoking over this period, and more than 500,000 people whom we would expect to have died before their mid-to-late 80s if they had started smoking instead of using e-cigarettes.

Because cigarette smokers are less productive due to illnesses and smoking breaks, e-cigarettes have also boosted productivity. E-cigarette users are on average $820 more productive per-year than ex-cigarette smokers and $2,371 more productive per-year than current smokers, and that ex-smokers who shifted to e-cigarettes are on average $1,554 more productive per-year than current smokers. In aggregate, the additional productivity from the nearly four million e-cigarette users is projected to increase national productivity by nearly $45 billion between 2017 and 2027.

A recent assessment by Dr. David Levy from Georgetown University estimates that e-cigarette use was responsible for 60 percent to 80 percent of the recent decline in cigarette smoking.

If smoking e-cigarettes led to regular cigarette smoking, we should observe rising cigarette smoking rates among those ages 18 to 24 in subsequent years, or at least an attenuated decline in their cigarette smoking. Instead, the CDC data show the opposite: Rates of cigarette smoking among those ages 18 to 24 declined from 17.0 percent in 2014 to 10.4 percent in 2017, suggesting the "gateway effect" is a myth. 

Read the full study here

Feature Charticle

Actual and Projected Smoking Rates, 2010-2017

PPI

Findings:

  • Cigarette smoking fell significantly between 2013 and 2017, with a statistical analysis suggesting that about 70 percent of the decline -- nearly four million people -- was associated with the rising use of e-cigarettes.  
  • This finding suggests that e-cigarettes are an effective tool to help people stop smoking or avoid starting to smoke cigarettes.
  • This data also suggests there's no "gateway effect" from e-cigarettes to smoking.