Potential impact of e-cigarettes on life-years lost from conventional smoking in Ukraine, a replication study

Smoking remains a significant public health concern in Ukraine. Recent efforts to combat smoking have shown some progress, but Ukraine's current approach largely overlooks the potential benefits of harm reduction strategies. Concurrently, the use of e-cigarettes has been on the rise among Ukrainian adults. Our study aims to estimate the potential impact of e-cigarettes on reducing the mortality rate associated with cigarette smoking in Ukraine.

We conducted a replication study using a dynamic population simulation model initially developed for the US. We ran simulations for 210 e-cigarette scenarios, varying assumptions on how e-cigarettes may affect smoking behaviour and health outcomes. A sensitivity analysis was performed to test the robustness of the results.

A substantial majority of e-cigarette scenarios (88.10%) resulted in positive life-years saved (LYS). The LYS ranged from -1.13 to 13.11 million, with a median of 3.17 million, accounting for 4.55% of the total life-years lost (LYL) due to smoking. Among the most plausible e-cigarette scenarios, the LYS varied from 2.73 to 4.88 million (3.92% to 6.99% of LYL due to smoking). Furthermore, these scenarios demonstrated that the long-term smoking prevalence would stabilize at around 5.56-6.40%.

Our simulation analysis demonstrates the potential of e-cigarettes to significantly reduce the burden of smoking in Ukraine. Most e-cigarette scenarios result in positive LYS, while scenarios with negative LYS are unlikely. These findings support the idea that the benefits of e-cigarettes outweigh potential harm, aligning with previous studies in other countries.