PDF(Pubmed)
Abstract：
Recent estimates indicated substantially replacing cigarettes by e-cigarettes would, during 2016-2100, reduce US deaths and life-years lost (millions) by 6.6 and 86.7 (Optimistic Scenario) and 1.6 and 20.8 (Pessimistic). To provide additional insight we use alternative modelling based on a shorter period (1991-2040), four main smoking-associated diseases, deaths aged 30-79 years, and a full product history. We consider variations in: assumed effective dose of e-cigarettes versus cigarettes (F); their relative quitting rate (Q); proportions smoking after 10 years (X); and initiation rate (I) of vaping, relative to smoking.
We set F = 0.05, X = 5%, Q = 1.0 and I = 1.0 (Main Scenario) and F = 0.4, X = 10%, Q = 0.5 and I = 1.5 (Pessimistic Scenario). Sensitivity Analyses varied Main Scenario parameters singly; F from 0 to 0.4, X 0.01% to 15%, and Q and I 0.5 to 1.5. To allow comparison with prior work, individuals cannot be dual users, re-initiate, or switch except from cigarettes to e-cigarettes.
Main Scenario reductions were 2.52 and 26.23 million deaths and life-years lost; Pessimistic Scenario reductions were 0.76 and 8.31 million. These were less than previously, due to the more limited age-range and follow-up, and restriction to four diseases. Reductions in deaths (millions) varied most for X, from 3.22 (X = 0.01%) to 1.31 (X = 15%), and F, 2.74 (F = 0) to 1.35 (F = 0.4). Varying Q or I had little effect.
Substantial reductions in deaths and life-years lost were observed even under pessimistic assumptions. Estimates varied most for X and F. These findings supplement literature indicating e-cigarettes can importantly impact health challenges from smoking.
We set F = 0.05, X = 5%, Q = 1.0 and I = 1.0 (Main Scenario) and F = 0.4, X = 10%, Q = 0.5 and I = 1.5 (Pessimistic Scenario). Sensitivity Analyses varied Main Scenario parameters singly; F from 0 to 0.4, X 0.01% to 15%, and Q and I 0.5 to 1.5. To allow comparison with prior work, individuals cannot be dual users, re-initiate, or switch except from cigarettes to e-cigarettes.
Main Scenario reductions were 2.52 and 26.23 million deaths and life-years lost; Pessimistic Scenario reductions were 0.76 and 8.31 million. These were less than previously, due to the more limited age-range and follow-up, and restriction to four diseases. Reductions in deaths (millions) varied most for X, from 3.22 (X = 0.01%) to 1.31 (X = 15%), and F, 2.74 (F = 0) to 1.35 (F = 0.4). Varying Q or I had little effect.
Substantial reductions in deaths and life-years lost were observed even under pessimistic assumptions. Estimates varied most for X and F. These findings supplement literature indicating e-cigarettes can importantly impact health challenges from smoking.
摘要：
最近的估计表明，用电子烟取代香烟将，在2016-2100年期间,美国死亡人数和寿命损失(百万)分别减少6.6和86.7(乐观情景)和1.6和20.8(悲观情景).为了提供额外的见解，我们使用基于较短周期(1991-2040)的替代模型，四种主要的吸烟相关疾病，30-79岁的死亡，完整的产品历史我们考虑以下方面的变化：电子烟相对于香烟的假定有效剂量（F）;它们的相对戒烟率（Q）;10年后吸烟的比例（X）;和vaping的起始率（I），相对于吸烟。
我们设置F=0.05，X=5%，Q=1.0，I=1.0（主要方案），F=0.4，X=10%，Q=0.5和I=1.5(悲观情景)。敏感性分析单独改变主要方案参数；F从0到0.4，X0.01%到15%，和Q和I0.5到1.5。为了与以前的工作进行比较，个人不能是双重用户，重新发起，或者从香烟切换到电子香烟。
主要情景减少了2.52和2623万死亡和生命年损失；悲观情景减少了0.76和831万。这些比以前少，由于年龄范围和后续行动较为有限，限制四种疾病。X的死亡人数减少（百万）差异最大，从3.22(X=0.01%)到1.31(X=15%)，F,2.74（F=0）至1.35（F=0.4）。改变Q或我没有什么效果。
即使在悲观的假设下，死亡人数和生命年损失也显著减少。X和F的估计差异最大。这些发现补充文献表明，电子烟可以对吸烟带来的健康挑战产生重要影响。
我们设置F=0.05，X=5%，Q=1.0，I=1.0（主要方案），F=0.4，X=10%，Q=0.5和I=1.5(悲观情景)。敏感性分析单独改变主要方案参数；F从0到0.4，X0.01%到15%，和Q和I0.5到1.5。为了与以前的工作进行比较，个人不能是双重用户，重新发起，或者从香烟切换到电子香烟。
主要情景减少了2.52和2623万死亡和生命年损失；悲观情景减少了0.76和831万。这些比以前少，由于年龄范围和后续行动较为有限，限制四种疾病。X的死亡人数减少（百万）差异最大，从3.22(X=0.01%)到1.31(X=15%)，F,2.74（F=0）至1.35（F=0.4）。改变Q或我没有什么效果。
即使在悲观的假设下，死亡人数和生命年损失也显著减少。X和F的估计差异最大。这些发现补充文献表明，电子烟可以对吸烟带来的健康挑战产生重要影响。
