The US SimSmoke tobacco control policy model of smokeless tobacco and cigarette use

Abstract

BackgroundSmokeless tobacco (SLT) prevalence had been declining in the US prior to 2002 but has since increased. Knowledge about the impact of tobacco control policies on SLT and cigarette use is limited. This study examines the interrelationship between policies, cigarette use, and SLT use by applying the SimSmoke tobacco control policy simulation model.MethodsUsing data from large-scale Tobacco Use Supplement and information on policies implemented, US SimSmoke was updated and extended to incorporate SLT use. The model distinguishes between exclusive SLT and dual use of SLT and cigarettes, and considers the effect of implementing individual and combined tobacco control policies on smoking and SLT use, and on deaths attributable to their use. After validating against Tobacco Use Supplement (TUS) survey data through 2015, the model was used to estimate the impact of policies implemented between 1993 and 2017.ResultsSimSmoke reflected trends in exclusive cigarette use from the TUS, but over-estimated the reductions, especially among 18–24 year olds, until 2002 and under-estimated the reductions from 2011 to 2015. By 2015, SimSmoke projections of exclusive SLT and dual use were close to TUS estimates, but under-estimated reductions in both from 1993 to 2002 and failed to estimate the growth in male exclusive SLT use, especially among 18–24 year olds, from 2011 to 2015. SimSmoke projects that policies implemented between 1993 and 2017 reduced exclusive cigarette use by about 35%, dual use by 32.5% and SLT use by 16.5%, yielding a reduction of 7.5 million tobacco-attributable deaths by 2067. The largest reductions were attributed to tax increases.ConclusionsOur results indicate that cigarette-oriented policies may be effective in also reducing the use of other tobacco products. However, further information is needed on the effect of tobacco control policies on exclusive and dual SLT use and the role of industry.

Trends in Tobacco Use Among Adolescents by Grade, Sex, and Race, 1991-2019

“…9 To our knowledge, this study is the first to consider recent trends in smokeless tobacco use increased marketing and encouraged dual use. [30][31][32] These actions seem to have resulted in a temporary increase in use; however, as for cigarettes, accelerated decreases in use were seen since approximately 2012.…”

“…In 2005, cigarette companies became active in the smokeless tobacco industry and by 2009 controlled more than 80% of the industry and increased marketing and encouraged dual use. 30 , 31 , 32 These actions seem to have resulted in a temporary increase in use; however, as for cigarettes, accelerated decreases in use were seen since approximately 2012.…”

US Nicotine Vaping Product SimSmoke Simulation Model: The Effect of Vaping and Tobacco Control Policies on Smoking Prevalence and Smoking-Attributable Deaths

“…Simulation models show that much of this reduction can be explained by smoking tobacco control policies [ 1 , 2 , 3 , 4 , 5 ], especially increased cigarette taxes, smoke-free air policies, media campaigns, restrictions on youth access to tobacco, and cessation treatment policies [ 1 , 6 ]. While simulation models project that US smoking prevalence will continue to decline under current policies [ 3 , 7 , 8 , 9 , 10 , 11 ], they also indicate that prevalence will not drop below 10% for at least another two decades. That trajectory may change now that NVPs are more widely used.…”

Predicting the Epidemiological Dynamics of Lung Cancer in Japan

“…Published modeling methods that employ statistical modeling techniques, including survival analysis and individual-based (micro)simulations, can also be used for similar assessments [8,9,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46], but manual control of the population at risk is required in these simplistic approaches. Our proposed model does not have to involve such manual input of the population size at risk because we explicitly model the demographic dynamics and examine the future course of smoking prevalence within our model directly when predicting the numbers of lung cancer cases [25,26,28,31,32,45]. Another direction of possible application would be to explore the effectiveness of additional screening, including regular or non-regular screening with chest X-rays or computed tomography, which is our area of ongoing future study [27,29,30,31,37,42,44].…”