News Release

E-Cigarette use costs US $15 billion per year, reports UCSF in first study of its kind

Peer-Reviewed Publication

University of California - San Francisco

Use of electronic cigarettes costs the United States $15 billion annually in health care expenditures — more than $2,000 per person a year — according to a study by researchers at the UC San Francisco School of Nursing

The study, published on May 23, 2022 in Tobacco Control, is the first to look at the health care costs of e-cigarette use among adults 18 and older. 

“Our finding indicates that health care expenditures for a person who uses e-cigarettes are $2,024 more per year than for a person who doesn’t use any tobacco products,” said lead author Yingning Wang, PhD, of the UCSF Institute for Health & Aging.

The researchers based their estimates of health care costs and utilization on data from the 2015-2018 National Health Interview Survey. Health care utilization included nights in the hospital, emergency room visits, doctor visits and home visits. 

“Health care costs attributable to e-cigarette use are already greater than our estimates of health care costs attributable to cigar and smokeless tobacco use,” said Wang. “This is a concerning finding, given that e-cigarettes are a relatively new product whose impact is likely to increase over time.”

Principal investigator Wendy Max, PhD, director of the Institute for Health & Aging, noted that from 2013 to 2018, e-cigarette use among high school students soared from 4.5% to 20.8%.

“We weren’t able to look at e-cigarette use among youth under 18 in this study,” Max said. “However, if more young people continue to take up vaping and keep on using this product when they become adults, the negative impacts on health care costs are likely to increase over time.” 

The authors called for continuing efforts to control tobacco use among youth in order to reduce illness and health care costs associated with e-cigarette use.  

“Even with the current relatively low use of e-cigarettes among adults — 3.7 percent — health care costs are already substantial, and likely to increase in the future if youth continue to use this product,” said Max. 

Authors: The senior author is Wendy Max, PhD, director of the UCSF Institute for Health & Aging. Co-authors are Yingning Wang, PhD; Hai-Yen Sung, PhD; and Tingting Yao, PhD, of the Institute for Health & Aging; and James Lightwood, PhD, of the UCSF School of Pharmacy.

Funding: National Heart, Lung, and Blood Institute (U54 HL147127) and FDA Center for Tobacco Products. The authors report no conflict of interest.  


About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF's primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at, or see our Fact Sheet.


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