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Color Key: Statistic with high certainty (e.g. population) Statistic with low certainty Open Philanthropy valueCalculationFinal calculation
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How much do we value e-cigarettes in the UK annually?
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Lower boundBest guessUpper boundSources/notes
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Total cigarette smokers UK6,900,0006,900,0006,900,000ASH, 2021 (smoking statistics)
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Total e-cigarette users UK3,600,0003,600,0003,600,000Ash, 2021
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GBD total smoking DALYs UK2,535,3392,718,6662,927,1272019 GBD
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Adjusted total smoking DALYs UK (GBD*.75)1,901,5042,039,0002,195,345
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OP value of a DALY$100,000$100,000$100,000
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Health benefits for those who use e-cigs to quit smoking:
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Percent e-cig users ex-smokers64.60%64.60%64.60%Ash, 2021
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N ex-smokers who use e-cigs2,325,6002,325,6002,325,600
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How much more effective are e-cigs for cessation?0.00%25%50%Wang et al., 2021 Meta-analysisIn 9 RCTS the cessation rate for conventional therapy was .086, and e-cig use increased absolute cessation rate by .04. This would mean the cessation rate is ~1.5 x higher when e-cigs are used. However, results from observational studies don't find large effects.
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N smokers would would have quit without e-cigs232560018604801550400
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N who quit due to e-cigs0465,120775,200
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Counterfactual N smokers 6,900,0007,365,1207,675,200
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How much did e-cigs reduce smoking rate? 0%-7%-11%
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Percent harm reduction for ex-smokers90.00%95.00%95.00%Royal College of Physicians, 2016 conclude e-cigs 95% safer. Warner, 2018 suggest the harm from e-cigarettes is at most 10% that of cigarettes.
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N DALYs saved from quitting0130,574234,310
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Value from cessation$0$13,057,398,382$23,431,017,464
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Harm reduction of dual users:
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Percent of ecig users who are dual users30.50%30.50%30.50%Ash, 2021
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Percent of ecig users who meaningfully reduced cig consumption15.25%15.25%15.25%Ash, 2021 (p. 5)Among dual users, ~50% vape daily. For now, I ignore any health benefits to dual users who vape less than daily (assume no change in their health)
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N dual users w/ reduced consumption549,000549,000549,000Assuming here that none of these smokers would have quit in absense of e-cigs, so any dual users would have continued "full" use of cigarettes in counterfactual
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Percent of smokers who reduced consumption8%8%8%
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Percent harm reduction for dual users who vape daily25.00%25.00%25.00%Very low confidence in this number. Average daily cigarettes consumed by UK smokers is ~10 (from NHS website). Rough calculation based on ASH, 2021 table 2 suggests dual users who vape daily smoke ~3.5 cigarettes fewer Quick google search found one article (based on Weber et al., 2021 study of cancer death in Australia) suggested lung cancer risk increased by ~7% with each daily cigarette.
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N DALYS saved from harm reduction 37,82340,55843,668
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Value from harm reduction in continued smokers$3,782,340,378$4,055,836,022$4,366,828,454
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Additional harm from never-smokers who use e-cigs
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Percent of ecig users who never smoked 4.90%4.90%4.90%Note - this is assuming that in the counterfactual, none of these e-cig users would have smoked. It is possible that at least some portion of these people would have been smokers in the counterfactual.
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Harm from ecigs (as % of cigarette DALYs)10%5%5%
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N DALYs CAUSED by e-cigarettes9,3174,9965,379
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Cost from additional e-cig users-$931,737,182-$499,554,885-$537,859,636
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Total value of e-cigs in the UK$2,850,603,197$16,613,679,518$27,259,986,283
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Major uncertainty to flag: This BOTEC is assuming that the avaliability of e-cigarettes did not increase smoking initiation. This assumption is based on papers such as Warner, 2018 suggesting teen smoking has not increased due to vaping. However, if some portion of smokers in the UK would not have been smokers in the counterfactual world with out e-cigarettes we should add an additional section estimating costs of increased smoking initiation.
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