The study calculates how much disease burden and direct healthcare costs in Germany fall when smokers switch to products without tobacco combustion such as vapes. Result for 2026 to 2040: around €15bn in savings in the conservative scenario, around €48bn in the realistic one and up to €75bn in the optimistic one.
Results
| Scenario | Savings in direct healthcare costs 2026 to 2040 |
|---|---|
| Conservative | around €15bn |
| Realistic | around €48bn |
| Optimistic | up to €75bn |
The savings cover direct healthcare costs only: hospital stays, treatment and care. Indirect costs such as lost working time are not included.
Small changes already matter: if 10 percent of smokers switch to vaping or other tools each year over three years, the model shows 8 to 10 percent fewer tobacco related cases and up to €3bn lower direct healthcare costs per year.
Three key messages
- Combustion does the damage, not primarily nicotine. Nicotine is not harmless. Most of the harm, however, comes from burning tobacco. International biomarker data analysed in the study show 60 to 95 percent fewer key toxicants after switching to e cigarettes.
- Harm reduction complements quitting, it does not replace it. Full abstinence remains the goal. Tobacco harm reduction addresses adults who would otherwise keep smoking.
- Regulation should be proportionate to risk. A clear distinction between cigarettes and non combustible products, binding quality standards, ingredient transparency and strict youth protection.
Method
The basis is a health economic microsimulation of 200,000 synthetic life courses, modelling scenarios of switching from smoking to vaping for 2026 to 2040. It is complemented by a systematic evidence review, structured expert interviews and sensitivity analyses. Academic quality assurance was provided by IU International University of Applied Sciences.
Fact sheet
| Title | Schadensminimierung beim Tabakkonsum in Deutschland (Tobacco harm reduction in Germany), in German |
|---|---|
| Client and funding | HG Innovation Limited (Heaven Gifts, brand ELFBAR) |
| Conducted by | IWCI, independently, with IU International University of Applied Sciences |
| Presented | Berlin, 15 April 2026 |
| Authors | Dominic Multerer (study lead, IWCI), Prof. Dr. Florian Hummel (academic quality assurance, IU), Dr. rer. nat. Bernhard Schropp (microsimulation) |
How to cite
Multerer, D.; Hummel, F.; Schropp, B. (2026): Schadensminimierung beim Tabakkonsum in Deutschland. Institut für Wachstumschancen und Innovation (IWCI) with IU Internationale Hochschule. Berlin.
Read the study (PDF, German) Publication by ELFBAR
FAQ
Who commissioned and paid for the study?
HG Innovation Limited, also known as Heaven Gifts, owner of the ELFBAR brand. IWCI conducted it independently, together with IU International University of Applied Sciences.
Which costs are included in the €15bn to €75bn?
Direct healthcare costs only: hospital stays, treatment and care in the period 2026 to 2040.
What is a microsimulation?
A model that simulates many individual life courses, here 200,000. It shows how smoking behaviour, disease and costs develop over years in different scenarios.