An Economic and Public Health Analysis of the Evolving Nicotine Marketplace

摘要/摘要 自从产品开发和营销扩大以来，烟草的使用模式发生了巨大的变化 尼古丁蒸发产品(NVP)和最近的加热烟草产品(HTP)。NVP正在被 由许多继续吸烟的成年吸烟者和那些已经戒烟的人使用 香烟。NVP也越来越多地被年轻人接受，这可能会鼓励 未来吸烟或取代吸烟。NVP和其他新兴尼古丁产品的净影响 以及政府为管制他们而实施的政策，以及最终对人口的影响 健康状况很难预测，这就是为什么对潜在的下游影响进行建模是有用的。的三个目标 这个项目是：1)开发行业行为的经济模型，以更好地了解行业的影响 对烟草控制政策的反应；2)制定一个框架，不仅包括卷烟和NVP 使用，但其他新的和新兴的产品，如HTPS；以及3)开发七个 对NVP和新兴尼古丁具有不同监管框架和产品使用模式的国家 产品。对于目标1，我们将开发行业对烟草控制政策的反应的经济模型， 考虑传统卷烟公司与非卷烟公司的作用，以更好地理解 市场结构、产品定价以及营销和产品开发的影响。对于目标2，我们将扩展 我们现有的模型是在当前的P01中开发的，用于预测NVP对吸烟和健康的影响 到目前为止，结果包括其他新兴的尼古丁产品，包括HTPs。我们将把这个框架应用于 了解以卷烟为导向、以NVP为导向和以HTP为导向的具体政策的影响 他们的组合。该框架还将解决行业行为、政策和 健康结果。对于AIM 3，将更新之前开发的美国、加拿大和英国型号，并 扩展到考虑HTP和更广泛的一套政策。还将开发新的国别模式 澳大利亚、日本、韩国和新西兰。我们提议的研究的首要目标是展示 烟草新产品对人群健康的潜在影响及以供应为导向的新产品的影响 关于烟草使用模式的法规和更传统的烟草控制需求减少政策。 将进行广泛的敏感性分析，以确定需要更好地了解的参数 以便预测人口健康影响并评估与以下方面有关的可能结果范围 具体的政策法规。

SUMMARY/ABSTRACT Patterns of tobacco use have changed dramatically since product development and marketing has expanded into nicotine vaping products (NVPs) and more recently heated tobacco products (HTPs). NVPs are being used by many adult smokers who continue to smoke cigarettes, and by those who have transitioned off of cigarettes. NVPs are also increasingly being taken up by youth and young adults in ways that may encourage future cigarette smoking or displace smoking. The net impact of NVPs and other emerging nicotine products and the policies that have been implemented by governments to regulate them and ultimately on population health are difficult to predict, which is why modelling potential downstream impacts is useful. The three aims of this project are: 1) to develop economic models of industry behavior to better understand the impact of industry reactions to tobacco control policies; 2) to develop a framework that not only incorporates cigarettes and NVP use, but other new and emerging products, such as HTPs; and 3) to develop simulation models for seven countries with different regulatory frameworks and product use patterns for NVP and emerging nicotine products. For Aim 1 we will develop economic models of industry reactions to tobacco control policies that consider the role of traditional cigarette companies versus non-cigarette companies to better understand the impact of market structure, product pricing, and marketing and product development. For Aim 2 we will expand our existing model developed in the current P01 to forecast the impact of NVPs on smoking and health outcomes to now include other emerging nicotine products, including HTPs. We will apply this framework to understand the impact of specific cigarette-oriented, NVP-oriented and HTP-oriented policies, individually and their combination. The framework will also address the interaction between industry behavior, policies, and health outcomes. For Aim 3, the previously developed US, Canada and England models will be updated and extended to consider HTPs and a broader set of policies. New country specific models will also be developed for Australia, Japan, Korea and New Zealand. Our overarching goal of the proposed research is to show the likely population health impacts of new tobacco products and the effect of new supply-oriented product regulations and the more traditional tobacco control demand-reduction policies on tobacco use patterns. Extensive sensitivity analysis will be conducted to identify the parameters that need to be better understood in order to forecast population health impacts and to evaluate the plausible range of outcomes associated with specific policies and regulations.