RT Journal Article
SR Electronic
T1 Healthcare utilisation and expenditures attributable to current e-cigarette use among US adults
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP tobaccocontrol-2021-057058
DO 10.1136/tobaccocontrol-2021-057058
A1 Yingning Wang
A1 Hai-Yen Sung
A1 James Lightwood
A1 Tingting Yao
A1 Wendy B Max
YR 2022
UL http://tobaccocontrol.bmj.com/content/early/2022/05/04/tobaccocontrol-2021-057058.abstract
AB Aims This study estimated annual healthcare expenditures attributable to current e-cigarette use among US adults, including current exclusive and dual/poly e-cigarette use.Methods Analysing the 2015–2018 National Health Interview Survey data, we estimated the impacts of e-cigarette use on healthcare utilisation among adults aged 18+ years. Healthcare utilisation outcomes were hospital nights, emergency room (ER) visits, doctor visits and home visits. Current e-cigarette use was categorised as exclusive and dual/poly e-cigarette use. The econometric model included two equations: health status as a function of e-cigarette use and other independent variables, and healthcare utilisation as a function of health status, e-cigarette use, and other independent variables. Using an ‘excess utilisation’ approach, we multiplied the e-cigarette-attributable fraction derived from the model by annual health expenditures to calculate healthcare expenditures attributable to current exclusive and dual/poly e-cigarette use, the sum of which were expenditures attributable to all current e-cigarette use.Results Current exclusive and dual/poly e-cigarette use, with 0.2% and 3.5% prevalence in 2015–2018, were associated with higher odds of reporting poor health status than never tobacco users. Poor health status was associated with higher odds of using the four healthcare services and a greater number of ER and doctor visits. Annual healthcare expenditures attributable to all current e-cigarette use was $15.1 billion ($2024 per user) in 2018, including $1.3 billion attributable to exclusive e-cigarette use ($1796 per user) and $13.8 billion attributable to dual/poly e-cigarette use ($2050 per user).Conclusion Adult current e-cigarette use was associated with substantial excess healthcare utilisation and expenditures.Not applicable. We used secondary data that are publicly available for our analysis.