Evidence map›Paper›PMID 28970328›Full record

ArticleTobacco control2018

Potential deaths averted in USA by replacing cigarettes with e-cigarettes.

David T Levy, Ron Borland, Eric N Lindblom, Maciej L Goniewicz, Rafael Meza, Theodore R Holford, Zhe Yuan, Yuying Luo, Richard J O'Connor, Raymond Niaura and 1 more

Abstract read
In one paragraph

Article in Tobacco control, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers.

0numbers the graph read from it
0cells of the map it votes in
99citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

99 citing papers in PubMed.

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  10. Policy lessons from a vaping ban, Singapore.Bulletin of the World Health Organization · 2025
    Article
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  18. Pleasure and Satisfaction as Predictors of Future Cigarette and E-cigarette Use: A Novel Two-Stage Modeling Approach.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024
    Observational
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  20. Article

39 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

David T LevyDepartment of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia, USA.
Ron BorlandNigel Gray Distinguished Fellow in Cancer Prevention, VicHealth Centre for Tobacco Control, The Cancer Council Victoria, Melbourne, Victoria, Australia.
Eric N LindblomO'Neill Institute for National & Global Health Law, Georgetown University Law Center, Washington, District of Columbia, USA.
Maciej L GoniewiczDepartment of Health Behavior, Division of Cancer Prevention and Population Studies, Roswell Park Cancer Institute, Buffalo, New York, USA.
Rafael MezaDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Theodore R HolfordDepartment of Biostatistics, Yale University, New Haven, Connecticut, USA.
Zhe YuanLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Yuying LuoLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Richard J O'ConnorDepartment of Health Behavior, Division of Cancer Prevention and Population Studies, Roswell Park Cancer Institute, Buffalo, New York, USA.
Raymond NiauraSchroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, District of Columbia, USA.
David B AbramsDepartment of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia, USA.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Vaporized Nicotine Product Initiation Among Youth in the US, Canada, and England: Methods to Predict Uptake and Policy EfficacyP01CA200512 · NCI · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI FONG, GEOFFREY T · 2016 to 2025
$25.3M
Comparative Modeling of Lung Cancer Prevention and Control PoliciesU01CA199284 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DE KONING, HARRY J, HOLFORD, THEODORE R · 2015 to 2019
$8.4M
MODELING THE POLICY IMPACT OF CIGARETTE AND SMOKELESS USE ON US MORTALITYR01DA036497 · NIDA · GEORGETOWN UNIVERSITY · PI LEVY, DAVID THEODORE · 2013 to 2016
$2.5M
A Simulation of Tobacco Policy, Smoking and Lung CancerU01CA097450 · NCI · PACIFIC INSTITUTE FOR RES AND EVALUATION · PI LEVY, DAVID THEODORE · 2002 to 2009
$2.1M
NCATS NIH HHS UL1 TR001863NCI NIH HHS P01 CA200512NCI NIH HHS U01 CA097450NCI NIH HHS U01 CA199284NIDA NIH HHS R01 DA036497
6 · The paper itself

Abstract

introductionUS tobacco control policies to reduce cigarette use have been effective, but their impact has been relatively slow. This study considers a strategy of switching cigarette smokers to e-cigarette use ('vaping') in the USA to accelerate tobacco control progress.

methodsA Status Quo Scenario, developed to project smoking rates and health outcomes in the absence of vaping, is compared with Substitution models, whereby cigarette use is largely replaced by vaping over a 10-year period. We test an Optimistic and a Pessimistic Scenario, differing in terms of the relative harms of e-cigarettes compared with cigarettes and the impact on overall initiation, cessation and switching. Projected mortality outcomes by age and sex under the Status Quo and E-Cigarette Substitution Scenarios are compared from 2016 to 2100 to determine public health impacts.

findingsCompared with the Status Quo, replacement of cigarette by e-cigarette use over a 10-year period yields 6.6 million fewer premature deaths with 86.7 million fewer life years lost in the Optimistic Scenario. Under the Pessimistic Scenario, 1.6 million premature deaths are averted with 20.8 million fewer life years lost. The largest gains are among younger cohorts, with a 0.5 gain in average life expectancy projected for the age 15 years cohort in 2016.

conclusionsThe tobacco control community has been divided regarding the role of e-cigarettes in tobacco control. Our projections show that a strategy of replacing cigarette smoking with vaping would yield substantial life year gains, even under pessimistic assumptions regarding cessation, initiation and relative harm.

Indexed as

Electronic Nicotine Delivery SystemsAdolescentAdultAgedAged, 80 and overAge FactorsCigarette SmokingFemaleHumansLife ExpectancyMaleMiddle AgedMortality, PrematurePublic HealthSmokersSmokingelectronic nicotine delivery devicesend gameharm reductionpublic policy

Identifiers

PMID28970328
PMCPMC5801653

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.