The Mexico SimSmoke tobacco control policy model: Development of a simulation model of daily and nondaily cigarette smoking

Abstract

Background Nondaily smoking has been on the rise, especially in Mexico. While Mexico has strengthened its tobacco control policies, their effects on nondaily smokers have gone largely unexamined. We developed a simulation model to estimate the impact of tobacco control policies on daily and nondaily smoking in Mexico. Methods A previously validated Mexico SimSmoke model that estimated overall trends in smoking prevalence from 2002 through 2013 was extended to 2018 and adapted to distinguish daily and nondaily smoking prevalence. The model was then validated using data from Mexican surveys through 2016. To gauge the potential effects of policies, we compared the trends in smoking under current policies with trends from policies kept at their 2002 levels. Results Between 2002 and 2016, Mexico SimSmoke underestimated the reduction in male and female daily smoking rates. For nondaily smoking, SimSmoke predicted a decline among both males and females, while survey rates showed increasing rates in both genders, primarily among ages 15–44. Of the total reduction in smoking rates predicted by the model by 2018, tax policies account for more than 55%, followed by health warnings, cessation treatment, smoke-free air laws, and tobacco control spending. Conclusions Although Mexico SimSmoke did not successfully explain trends in daily and nondaily smoking, it helps to identify gaps in surveillance and policy evaluation for nondaily smokers. Future research should consider appropriate measures of nondaily smoking prevalence, trajectories between daily and nondaily smoking, and the separate impact of tobacco control policies on each group.

The distributional effects of tobacco tax increases across regions in Mexico: an extended cost-effectiveness analysis

“…Although our estimates of costs avoided due to the tax increase consider inequalities in health care access across income groups and regions, they do not capture possible differences in average costs between regions. Third, although the evidence suggests that it is reasonable to assume that half of current smokers will die from tobacco attributable diseases [ 16 , 30 ], attributable mortality estimates might be less accurate than those from more complex models that follow a hypothetical cohort for which they calculate individual annual risks of disease incidence, disease progression and death [ 6 , 21 ]. The main contribution of this model, however, lies in that it provides a better understanding of the distribution of tobacco attributable deaths and, therefore, the distribution of tax benefits across income groups and regions using a relatively simple specification.…”

“…Specifically, this compartmental model estimates, by income quintile, life-years gained, smoking attributable deaths averted, treatment costs averted, number of persons avoiding poverty and catastrophic health expenditures, and additional tax revenues that would result from tobacco excise tax increases. While other simulation models have provided evidence on the potential effects of a substantial tobacco tax increase in Mexico, none of them have calculated distributional impacts [ 6 , 21 ].…”

“…Sensitivity analyses, however, consider a 1.15 pesos tax increase (from 0.4944 to 1.6444 pesos) that corresponds to a 50% price increase. This alternative scenario has been considered in other simulation models and previous versions of the GTEC ECEA [ 6 , 16 , 21 ].…”

Beneficios del impuesto a los cigarros en México: análisis por sexo y quintil de ingreso

“…El modelo ECEA del Consorcio Global de Economía del Tabaco (GTEC) (18) es un modelo compartimental que estima los años de vida ganados, las muertes prematuras, los costos de atención médica atribuibles al tabaco, los gastos catastróficos y los casos de pobreza evitados, además de la recaudación adicional por el incremento del impuesto a los cigarros. A diferencia de otros modelos de simulación que solo evalúan el impacto global de los impuestos (16,19) este modelo estima, además, los efectos por quintil de ingreso, lo que permite un análisis detallado entre los grupos de población más vulnerable.…”

“…Los costos de tratamiento de las enfermedades consideradas provienen de estudios previos sobre costos atribuibles al tabaquismo en México que han sido empleados en otros modelos de simulación (16,19). Estas cifras se actualizaron mediante el índice de precios al consumidor (INPC).…”