Vaping Harm-Reduction & Population Tradeoff Simulator

Policy & Epidemiological Presets

Relative Toxicity vs. Combustible 5%

UK Royal College benchmark ~5%; Skeptics estimate 15–30% long-term.

Adult Cessation Rate Multiplier 1.95x

Cochrane meta-analysis: E-cigs offer ~1.9x cessation rate over NRT/unassisted.

Youth Vaping Annual Initiation 4.2%

Percentage of never-smoking youth (ages 14-24) who take up regular vaping annually.

Youth Gateway to Cigarettes 12%

Proportion of youth vapers who eventually transition to combustible cigarettes.

Dual-Use Proportion among Switchers 30%

Smokers who vape but also continue reduced cigarette smoking (50% harm reduction).

Initial Adult Smoker Cohort 10.0 M

Starting baseline combustible tobacco population for 30-year Markov modeling.

Net 30-Year QALY Impact +3.42 M Quality-Adjusted Life Years Gained

Premature Deaths Averted 482,100 Combustible mortality reduction

Youth Gateway Penalty -38,400 Excess smoking deaths induced

Harm-Benefit Ratio 12.6 : 1 Cessation benefit per youth casualty

30-Year Markov Cohort Trajectories: Combustible vs. Vaping vs. Abstinent

Combustible Smokers

Exclusive Vapers

Dual Users

Abstinent / Non-Smokers

Cumulative QALY Ledger: Adult Cessation Benefit vs. Youth Gateway Cost

Adult Cessation Gain

Youth Initiation & Gateway Loss

Net Public Health Vector

Epidemiological Synthesis & Tradeoff Threshold Analysis

Under the current parameters, adult smoking cessation benefits significantly outweigh the population harms of youth vaping initiation. To reverse this net benefit, relative e-cigarette toxicity would have to exceed 48% or the youth gateway rate would need to surge beyond 64%.

Break-Even Toxicity Threshold: 38.4% (above this, vaping harms outweigh cessation gains)

Critical Youth Gateway Ceiling: 52.1% (transition rate where net QALY reaches zero)