E-cigarette use linked to $15B in healthcare spending, study finds

Adult e-cigarette use is associated with substantially higher rates of healthcare utilization and led to $15.1 billion in healthcare spending in 2018, according to a study published May 23 in Tobacco Control.

The study analyzed 109,133 U.S. adults using 2015 to 2018 National Health Interview Survey data to estimate the effect of e-cigarette use on healthcare utilization among those over 18. Healthcare utilization outcomes included hospital nights, emergency room visits, physician visits and home visits.

E-cigarette use among young adults increased from 2.4 percent in 2012 to 7.6 percent in 2018, but prevalence among all adults was 3.2 percent in 2018.

Three key takeaways:

Exclusive and dual/poly e-cigarette use, with 0.2 percent and 3.5 percent prevalence from 2015 to 2018, were associated with higher chances of reporting poor health status than non-tobacco users. Exclusive users were 1.62 times more likely to report poor health status, while dual/poly e-cigarette users were 1.75 times more likely.

Poor health status was associated with higher chances of using the four healthcare services and a larger number of ER and physician visits.

Annual healthcare expenditures from all e-cigarette use was $15.1 billion, or $2,024 per user, in 2018. Of that, $1.3 billion was attributable to exclusive e-cigarette use ($1,796 per user) and $13.8 billion was attributable to dual/poly e-cigarette use ($2,050 per user).

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