PROJECT 5: IMPACT OF CHANGING TOBACCO PRODUCT USE ON HEALTHCARE COSTS FOR GENERAL AND VULNERABLE POPULATIONS

项目摘要/摘要 医疗成本在FDA监管影响分析中发挥着核心作用。导致烟草的因素有很多- 可归因性医疗成本，包括改变烟草产品使用模式、社会人口 特征、健康状况和社会经济地位(SES)。这个项目的中心目标是 开发经济模型，分析烟草产品使用的新模式对 不同人群的医疗费用，包括那些特别脆弱的人群。该项目 重点关注吸烟、电子烟的使用和多种烟草的使用，作为当今常见的烟草使用模式， 以及农村/城市地位、社会保障水平低、医疗并存和青年等因素 在这方面，儿童特别容易受到烟草使用的影响。这一目标将通过以下方式实现 四个具体目标：(1)开发微观经济模型，以估算可归因于电子-- 香烟使用；(2)估计易受伤害人群因吸烟和使用电子烟而产生的医疗费用 人群：SES低的人群、农村人群、医疗并存人群和青年；(3) 开发微观经济模型，以估计最常见的 烟草产品用途的组合：香烟和电子烟的双重用途；香烟和雪茄的双重用途； 和多次使用香烟、电子烟和其他烟草产品；以及(4)分析潜在的情景以 根据研究结果确定监管变化对医疗成本的可能影响 由加州大学旧金山分校TCORS的同事在实验室和对照人体研究中进行。烟草-可归因于 将使用计量经济学模型和事实/反事实方法估计医疗费用，其中 将感兴趣的产品(S)的用户的成本(即，事实案例)与人的成本进行比较 具有与吸烟者相同的特征，只是他们被假定为从不吸烟者或 吸烟者，取决于相关的对照群体(即反事实案件)。这个项目 介绍加州大学旧金山分校的TCORS主题：“了解综合的健康影响、行为和影响 分析将提供可操作的信息，用于监管和宣传当前和 通过开发烟草使用对健康结果的影响的经济模型，“新兴烟草产品” 和医疗保健成本，并在模拟中整合实验室和人体研究的健康影响 产品特性和可用性的变化对医疗保健利用率和成本的影响。这个 此外，还将模拟农村青少年吸烟行为与失学天数的关系。这 信息被纳入经济模型，以改进影响分析。医疗保健成本估算 该项目将提供有用的指标来衡量烟草使用对公共健康的影响，允许 不同烟草产品对特定人群健康影响的相对大小的比较。

PROJECT SUMMARY/ABSTRACT Healthcare costs play a central role in FDA regulatory impact analysis. Many factors contribute to tobacco- attributable healthcare costs, including changing tobacco product use patterns, sociodemographic characteristics, health status, and socioeconomic status (SES). The central goal of this project is to develop economic models that analyze the impact of new patterns of tobacco product use on healthcare costs for different populations including those that are particularly vulnerable. The project focuses on cigarette smoking, e-cigarette use, and polytobacco use as common tobacco use patterns today, and on rural/urban status, low SES, medical co-morbidities, and youth as examples of factors that cause population groups to be particularly vulnerable to tobacco use. The goal will be accomplished by addressing four specific aims: (1) Develop microeconomic models to estimate the healthcare costs attributable to e- cigarette use; (2) Estimate healthcare costs attributable to cigarette smoking and e-cigarette use for vulnerable populations: people with low SES, rural populations, people with medical co-morbidities, and youth; (3) Develop microeconomic models to estimate the healthcare costs attributable to the most common combinations of tobacco product use: dual use of cigarettes and e-cigarettes; dual use of cigarettes and cigars; and polyuse of cigarettes, e-cigarettes, and other tobacco products; and (4) Analyze potential scenarios to determine the likely impact of regulatory changes on healthcare costs based on findings from research conducted by UCSF TCORS colleagues in laboratory and controlled human studies. Tobacco-attributable healthcare costs will be estimated using econometric models and a factual/counterfactual approach, in which costs among users of the product(s) of interest (i.e., the factual case) are compared with costs among people with identical characteristics as the users except that they are assumed to be never tobacco users or sole cigarette smokers, depending on the relevant comparison group (i.e., the counterfactual case). This project addresses the UCSF TCORS theme that “understanding combined health effects, behavior, and impact analysis will provide actionable information for regulation of and public communications about current and emerging tobacco products” by developing economic models of the impact of tobacco use on health outcomes and healthcare costs and integrating health effects from laboratory and human studies in simulations of the impact on healthcare utilization and costs from changes in product characteristics and availability. The relationship of tobacco use behavior and lost school days among rural youth will also be modeled. This information is incorporated into economic models to improve impact analyses. The healthcare cost estimates from this project will be useful metrics for measuring the impact of tobacco use on public health, allowing a comparison of the relative magnitude of health effects of different tobacco products on specific populations.