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RESEARCH ARTICLE
Contents Vol 48(1)

Healthcare costs attributable to e-cigarette use and subsequent uptake of cigarette smoking by Australians who have never smoked

Louisa G. Gordon https://orcid.org/0000-0002-3159-4249 A B C * and Paige Preston C D
+ Author Affiliations
- Author Affiliations

A QIMR Berghofer Medical Research Institute, Population Health Program, Brisbane, Qld, Australia.

B School of Nursing, Queensland University of Technology (QUT), Brisbane, Qld, Australia.

C School of Public Health, The University of Queensland, Brisbane, Qld, Australia.

D Lung Foundation Australia, Level 2/11 Finchley Street, Milton, Qld 4064, Australia.

* Correspondence to: louisa.gordon@qimrberghofer.edu.au

Australian Health Review 48(1) 52-57 https://doi.org/10.1071/AH23178
Submitted: 10 May 2023  Accepted: 1 December 2023  Published: 22 December 2023

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

New legislation to curb the rapid increase in e-cigarette use among youth is underway. We estimated the future healthcare costs for chronic diseases from e-cigarette use among never smokers who transition to tobacco smoking.

Methods

Using population-attributable fractions, we estimated the health expenditure attributable to e-cigarettes based on the prevalence of e-cigarette use, uptake of tobacco smoking, and risk of smoking on developing chronic disease. Data for men and women were derived from published reports on e-cigarette use prevalence, risk of smoking-related disease and addiction, and health expenditure for 25 diseases. Sensitivity analyses were undertaken to address data input variation.

Results

Future healthcare costs attributed to new e-cigarette-initiated smokers were conservatively estimated to be (in Australian dollars) $179.6 million annually. Collectively, the estimated costs were highest for respiratory diseases ($102.2 million; 57% of total costs), malignant cancers ($49.6 million; 28%), and cardiovascular disease ($27.7 million; 15%). The uptake rate of e-cigarettes was more important in driving healthcare costs than the proportion moving from e-cigarettes to cigarette smoking.

Conclusion

High avoidable health system costs are predicted for the treatment of chronic conditions created by e-cigarette-initiated smoking. These costs exclude the immediate and direct healthcare harms of e-cigarette-related poisoning, lung injury, and respiratory problems, and costs associated with the unknown health harms of e-cigarette use alone. The proposed regulations to curb recreational e-cigarette use in Australia are set to prevent expensive health care arising sometime in the future from new cigarette smokers.

Keywords: cost analysis, e-cigarette, electronic nicotine delivery system, healthcare costs, vaping.

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