Global Burden of Non-Communicable Diseases from E-Cigarette Exposure: Trend Analysis and 2050 Projections

The global rise in e-cigarette use has sparked significant public health concerns, particularly regarding its potential association with major non-communicable diseases (NCDs), including chronic respiratory conditions, cardiovascular diseases, and mental health disorders. A systematic evaluation of the NCD burden attributable to e-cigarettes is critically needed to inform policy. Therefore, this study aims to quantify the burden of major NCDs attributable to e-cigarette use between 2010 and 2021 and project future trends through 2050. This study used deidentified 2010–2021 NCD data from GBD 2021. We applied a comparative risk assessment framework to estimate the burden of NCDs attributable to e-cigarette use and used a generalized additive model to project future trends. We found that between 2010 and 2021, global prevalence of current e-cigarette use increased from 0.90% (95% CI, 0.46–1.48) to 8.73% (95% CI, 5.24–12.99). During this period, prevalent cases and DALYs for major NCDs showed consistent upward trends worldwide. Notably, NCD DALYs attributable to e-cigarette use increased from 2010 to 2021. Projections indicate that this concerning trend will continue, with marked increases in e-cigarette-attributable NCD burden anticipated through 2050. This study demonstrates the urgent need to incorporate electronic cigarette control measures into NCD prevention strategies, particularly targeting adolescent populations where usage rates are rising most rapidly.