```html The Vaping Tradeoff: Harm Reduction vs. Youth Uptake Simulator
Epidemiological Policy Simulator

The Vaping Tradeoff: Harm Reduction vs. Youth Uptake

Simulate 20-year net population health outcomes (QALYs & premature mortality) across a 1,000,000-person cohort by balancing adult smoking cessation gains against youth nicotine initiation risks.

Net Population Balance
+284,500
Net Quality-Adjusted Life Years (QALYs)
Averted Premature Deaths
18,420
Adult smokers saved from fatal illness
Youth Residual Harm Cost
-42,150
QALYs lost via youth uptake & gateway

Population Prevalence Trajectory

Cohort transitions (N=1,000,000) over time

Combustible Smokers
Exclusive Vapers
Sustained Quitters
Dual Users

Epidemiological Balance Sheet

Gross QALY Gains vs. Attributable Losses

Smoking Cessation Benefit
Youth Gateway & Vaping Toxicity Cost

Demographic Cohort Breakdown

Final projected status at year horizon

Cohort / User Segment Headcount Net QALY Impact

Parameter Sensitivity Ranking

Impact on Net QALYs (±25% variation)

Epidemiological Assumptions & Evidence Base

Derived from Cochrane Reviews, UK Royal College of Physicians, and US FDA/CDC Population Assessment of Tobacco and Health (PATH) studies.

Adult Smoking Cessation Efficacy

High-certainty evidence from Cochrane Systematic Reviews (2024) indicates nicotine e-cigarettes lead to higher 6-month cessation rates than nicotine replacement therapy (NRT) patches/gums (Relative Effect 1.63, 95% CI 1.30 to 2.04). In this model, cessation yields an average recovery of ~5.5 discounted QALYs per successful quitter compared to continuous lifetime combustible smoking.

Ref: Cochrane Database of Systematic Reviews 2024, Issue 1. Art. No.: CD010216.

Residual Harm & Youth Gateway Risks

While vapor contains far fewer toxic combustion byproducts (PAHs, carbon monoxide, nitrosamines), residual risks include pulmonary inflammation and heavy metal traces. A potential gateway effect where e-cigarette experimentation increases initiation into combustible tobacco carries high negative QALY weighting (-8.0 QALYs per lifetime smoking transition).

Ref: Royal College of Physicians UK, "E-cigarettes and harm reduction" (2021) & NASEM Consensus Study.