David T Levy1, Zhe Yuan2, Yameng Li. 1. Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St., Suite 4100, Washington DC, USA. dl777@georgetown.edu. 2. Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St., Suite 4100, Washington DC, USA.
Abstract
BACKGROUND: Smokeless 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. METHODS: Using 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. RESULTS: SimSmoke 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. CONCLUSIONS: Our 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.
BACKGROUND: Smokeless 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. METHODS: Using 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. RESULTS: SimSmoke 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. CONCLUSIONS: Our 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.
Entities:
Keywords:
Simulation model; Smokeless tobacco; Tobacco control policies
Authors: Karin A Kasza; Bridget K Ambrose; Kevin P Conway; Nicolette Borek; Kristie Taylor; Maciej L Goniewicz; K Michael Cummings; Eva Sharma; Jennifer L Pearson; Victoria R Green; Annette R Kaufman; Maansi Bansal-Travers; Mark J Travers; Jonathan Kwan; Cindy Tworek; Yu-Ching Cheng; Ling Yang; Nikolas Pharris-Ciurej; Dana M van Bemmel; Cathy L Backinger; Wilson M Compton; Andrew J Hyland Journal: N Engl J Med Date: 2017-01-26 Impact factor: 91.245
Authors: David T Levy; Alex C Liber; Christopher Cadham; Luz Maria Sanchez-Romero; Andrew Hyland; Michael Cummings; Cliff Douglas; Rafael Meza; Lisa Henriksen Journal: Tob Control Date: 2022-01-24 Impact factor: 6.953
Authors: David T Levy; Luz María Sánchez-Romero; Nargiz Travis; Zhe Yuan; Yameng Li; Sarah Skolnick; Jihyoun Jeon; Jamie Tam; Rafael Meza Journal: Int J Environ Res Public Health Date: 2021-05-03 Impact factor: 4.614