A modeling approach to gauging the effects of nicotine vaping product use on cessation from cigarettes: what do we know, what do we need to know?
A modeling approach to gauging the effects of nicotine vaping product use on cessation from cigarettes: what do we know, what do we need to know?
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DOI：
10.1111/add.14530
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发表时间：
2019-10-01
期刊：
影响因子：
6
通讯作者：
Cummings, K. Michael
中科院分区：
文献类型：
--
作者：
Levy, David T.;Yuan, Zhe;Cummings, K. Michael
吸烟者使用尼古丁蒸汽产品（NVP）对人群健康的长期影响尚不清楚，并且受到一系列关于NVP使用和健康后果的合理假设的影响。虽然NVP的使用可以替代吸烟，从而有助于戒烟，但也有可能是吸烟者本来会戒烟，而不是推迟戒烟。我们的目的是开发一个队列特定的模拟模型，NVP对成年吸烟者戒烟的影响，并导致过早死亡（PD）和生命年损失（LYL）。2012年，针对年龄为30岁和50岁的两个出生队列，按性别开发了NVP对成年吸烟者戒烟以及由此导致的过早死亡（PD）和生命年损失（LYL）影响的队列特异性模拟模型。进行了广泛的敏感性分析。设置美国。2012年，两个出生队列中的吸烟者，年龄分别为30岁和50岁。数据来自1965-2012年全国健康访谈调查和2014/15年当前人口调查的烟草使用补充。该模型纳入了一系列来自已发表文献的合理假设，这些假设涉及从常规吸烟到专用NVP和双重使用、从双重使用到专用NVP使用以及从专用NVP使用到不使用的转换率。结果与无NVP情景相比，男性（女性）模型预测1982年队列的PD减少17.8%（19.3%），LYL减少22.9%（26.6%），1962年队列的PD减少5.4%（7.3%），LYL减少7.9%（11.4%）。这些增益对NVP随时间的使用、初始NVP使用的年龄、从吸烟到双重NVP的过渡、单独NVP和不使用以及相对NVP死亡率风险敏感。结论：尼古丁电子烟产品（NVP）在美国的使用预计将对人口健康产生净积极影响，在广泛的合理NVP使用水平，过渡到双重，独家NVP和不使用NVP风险。但是，净影响对参数估计值很敏感。
Background and aims The long-term population health impact of nicotine vaping products (NVPs) use among smokers is unknown, and subject to a range of plausible assumptions about the use and health consequences of NVPs. While NVPs use may substitute for cigarette smoking and thereby aid in quitting cigarette use, it is also possible that smokers who would have otherwise quit would instead delay quitting cigarettes. We aimed to develop a cohort-specific simulation model of the impact of NVPs on smoking cessation by adult smokers and resulting premature deaths (PD) and life years lost (LYL). Design A cohort-specific simulation model of the impact of NVPs on smoking cessation by adult smokers and resulting premature deaths (PD) and life years lost (LYL) was developed by gender for two birth cohorts, aged 30 and 50 years in 2012. Extensive sensitivity analyses were conducted. Setting United States. Participants Smokers in two birth cohorts, aged 30 and 50 years in 2012. Measurements Data were from the 1965-2012 National Health Interview Surveys and the 2014/15 Tobacco Use Supplement of the Current Population Survey. The model incorporated a range of plausible assumptions from published literature about transition rates from regular smoking to exclusive NVP and dual use, from dual use to exclusive NVP use and from exclusive NVP use to no use. Findings Compared with the no-NVP scenario, the male (female) model projected 17.8% (19.3%) fewer PDs and 22.9% (26.6%) fewer LYL for the 1982 cohort and 5.4% (7.3%) fewer PDs and 7.9% (11.4%) fewer LYL for the 1962 cohort. These gains were sensitive to NVP use over time, age of initial NVP use, transitions from smoking to dual, exclusive NVP and no use and relative NVP mortality risks. Conclusions Nicotine vaping product (NVP) use in the United States is projected to have a net positive impact on population health over a wide range of plausible levels of NVP use, transitions to dual, exclusive NVP and no use and NVP risks. However, net impact is sensitive to parameter estimates.