Comparison of Tobacco Control Scenarios: Quantifying Estimates of Long-Term Health Impact Using the DYNAMO-HIA Modeling Tool

Abstract

BackgroundThere are several types of tobacco control interventions/policies which can change future smoking exposure. The most basic intervention types are 1) smoking cessation interventions 2) preventing smoking initiation and 3) implementation of a nationwide policy affecting quitters and starters simultaneously. The possibility for dynamic quantification of such different interventions is key for comparing the timing and size of their effects.Methods and ResultsWe developed a software tool, DYNAMO-HIA, which allows for a quantitative comparison of the health impact of different policy scenarios. We illustrate the outcomes of the tool for the three typical types of tobacco control interventions if these were applied in the Netherlands. The tool was used to model the effects of different types of smoking interventions on future smoking prevalence and on health outcomes, comparing these three scenarios with the business-as-usual scenario. The necessary data input was obtained from the DYNAMO-HIA database which was assembled as part of this project. All smoking interventions will be effective in the long run. The population-wide strategy will be most effective in both the short and long term. The smoking cessation scenario will be second-most effective in the short run, though in the long run the smoking initiation scenario will become almost as effective. Interventions aimed at preventing the initiation of smoking need a long time horizon to become manifest in terms of health effects. The outcomes strongly depend on the groups targeted by the intervention.ConclusionWe calculated how much more effective the population-wide strategy is, in both the short and long term, compared to quit smoking interventions and measures aimed at preventing the initiation of smoking. By allowing a great variety of user-specified choices, the DYNAMO-HIA tool is a powerful instrument by which the consequences of different tobacco control policies and interventions can be assessed.

Population Attributable and Preventable Fractions: Cancer Risk Factor Surveillance, and Cancer Policy Projection

“…Attainable targets can also be defined as the level of an exposure that is observed in other populations [27], or in the same population at a different point in time [28]. Exposure changes due to interventions are usually modelled based on the results of studies that examine how these interventions affect the exposure distribution (which should take into account the potential participation rate if applicable [29]) [30, 31]. Another utility of the PPF is its use in assessing cost-effectiveness, and, to determine the cost-effective minimum, the intervention(s) that produce the maximum health gain for the lowest economic cost.…”

Tobacco Cessation in India: How Can Oral Health Professionals Contribute?

“…(Slama, 2004) Tobacco cessation leads to short-term health benefits and curbs the tobacco death burden in the long-term. (US, 1990;Kulik et al, 2012;Peto et al, 1994) Both smokers and smokeless tobacco users have substantial benefits from cessation. Smokers who quit before 50 years of age reduce their risk of dying in the next 15 years to half that of a continuing smoker.…”

Modelling obesity outcomes: reducing obesity risk in adulthood may have greater impact than reducing obesity prevalence in childhood

“…Modelling the likely impact of interventions on the development of obesity is needed , and the present paper explores this issue using an established risk factor focused modelling tool DYNAMO‐HIA (Dynamic Modelling for Health Impact Assessment). This modelling tool has been used to analyse the effects of changes in smoking behaviour and alcohol consumption in the European Union (EU) . In this application, we focus on the life course of a population cohort, in order to compare the effects of two types of interventions: Interventions which reduce the number of overweight/obese individuals in a cohort that enters adulthood.…”