A scenario-based modeling study to project the future burden of COPD in Western Europe accounting for air pollution, tobacco smoking, and e-cigarette vaping

<bold>Rationale:</bold> COPD is imposing an immense economic and health burden. Previous modeling work quantified the burden of COPD across North America in terms of direct costs, indirect costs, and exacerbation frequency, accounting for COPD risk factors such as smoking and air pollution. We extended this modeling by also accounting for the effects of e-cigarettes (vaping). Considering for multiple risk factors, we sought to project economic and health burden of COPD across Western Europe by 2050. <bold>Methods:</bold> Using data derived from publicly available datasets, a Markov model was developed to simulate population dynamics from 2019 to 2050. Population growth and mortality were modeled across different subgroups of age, sex, tobacco smoking, and vaping. Direct costs, indirect costs, and the number of exacerbations and hospitalizations were projected in Western Europe (n_countries = 12) to 2050. <bold>Results:</bold> Incremental increases in the economic and health burden of COPD associated with vaping across Western Europe through 2050 are projected (Table). <fig><object-id>erj;64/suppl_68/OA4674/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusions:</bold> Including vaping as an additional risk factor incrementally increased the economic and health burden of COPD through 2050 across Europe. Public health efforts targeting COPD risk factors may be critical to prevent this anticipated increase in the burden of COPD.