Econometric modelling to study dynamic health behaviours at an individual, household, birth cohort a local authority level.

自1974年以来，英国的吸烟率一直在下降，最新的官方报告估计，目前有15.1%的成年人吸烟。然而，英国仍有760万烟民，最新统计显示，77,900人死于吸烟引起的疾病。因此，吸烟仍然是英国的一个主要公共卫生问题，就像许多经合组织国家一样。这项研究建议通过使用一种新的概念和方法，即动态方法，扩大我们对吸烟趋势的理解。这种方法使用了一段时间内的重复观察，从而可以研究随时间的变化。在吸烟行为的背景下，这将需要研究吸烟状态之间和吸烟状态内的转换和持续性以及决定这一点的因素，以及从健康经济和政策角度来看其后果。这里提出的研究将使用从到四个分析单元的重复观察来理解：1）个人和家庭特征以及社会和空间相互作用对个人一生中吸烟决定的作用; 2）文化规范、风险态度和风险偏好在吸烟代际传递中的作用; 3）出生队列的作用（或朋辈互动），以扩展我与特区政府的工作，4）通过研究英国地方当局地区的吸烟行为，观察到吸烟状态之间和吸烟状态内的空间转换和持续性的作用。由于吸烟越来越集中在某些人口亚群中，本研究建议在将要进行的经验模型中增加分组分析。要探讨的主要亚组是性别，社会经济地位和有心理健康问题的人群，但我将探讨社会经济地位和心理健康的不同定义，以便更深入地了解这些群体中吸烟行为的转变和持续性以及一般的吸烟不平等。只有在观察数量允许的情况下，才能进行亚组分析。吸烟行为的研究不能脱离过去40年来英国实施的大量和各种烟草控制政策。因此，本研究旨在探讨这些政策对个人，家庭和总的社会群体之间的吸烟行为动态的影响。对于使用个体水平数据的政策评估模型，本研究将需要考虑到个体在其一生中可以在吸烟状态之间转换的事实，从而探索将吸烟状态作为随时间变化的暴露的方法。政策分析将以因果推论的最新发展为基础，特别是在适当的情况下探索新的匹配和加权技术。本文建议的研究将从两个可能的方面扩展：第一，向特区政府提供资料;第二，研究将吸烟行为与其他不健康生活方式行为（例如酗酒）结合起来的联合收割机纵向数据集，不健康的饮食和久坐不动，如布拉德福德出生研究（BiB）所载。通过向特区政府提供投入，这项研究将使人们能够进一步探索与吸烟行为动态相关的健康和经济成本，并为个人、家庭、出生队列和地方当局地区创建特定模型，以全面理解吸烟作为一种社会、健康和经济行为。通过探索BiB，这项研究将研究家庭层面的吸烟行为动态与自怀孕以来一直跟踪的特定队列背景下的其他不健康行为之间的关系。

Smoking prevalence has consistently decreased in the UK since 1974, with the latest official reports estimating that 15.1% of the adult population currently smokes. However, there are still 7.6 million smokers and the latest statistics for England suggest that 77,900 people die from diseases caused by smoking. Therefore, smoking continues to be a major public health problem in the UK, as it is for many of the OECD countries. This research proposes to expand our understanding of smoking trends by using a new conceptual and methodological approach, namely a dynamic approach. This approach uses repeated observations through time, which allows studying changes over time. In the context of smoking behaviour, this will entail studying transitions and persistence between and within smoking states and factors determining this, as well as its consequences from a health economic and policy perspective.The research here proposed will use repeated observations from to four units of analysis to understand: 1) the role of individual and family characteristics as well as the role of social and spatial interactions on the individual's life course smoking decision; 2) the role of cultural norms, risk attitudes and risk preferences in the intergenerational transmission of smoking; 3) the role of birth cohort (or peer interaction) on smoking behaviour in order to expand the work I have been doing with SARG, and 4) the role of space on transitions and persistence between and within smoking status observed through studying smoking behaviour at a Local Authority District level in the UK.Since smoking is increasingly concentrated among certain population subgroups, this research proposes to add subgroup analysis to the empirical models that will be performed. The main subgroups to explore are gender, socioeconomic status and population with mental health issues, but I will explore different definitions of socioeconomic status and mental health to have a deeper understanding about transitions and persistency in smoking behaviour in each of these groups and about smoking inequalities in general. Subgroup analyses will only be performed when the number of observations allow us to do so.Smoking behaviour cannot be studied in isolation from the large number and variety of tobacco control policies that have been implemented in the UK during the last forty years. Hence, this research intends to explore the effect of these policies on smoking behaviour dynamics among individuals, households and aggregate social groups. For policy evaluation models using individual level data, this research will need to account for the fact that individuals can transition between smoking states throughout their life course, thus explore methods to use smoking status as a time-varying exposure. Policy analysis will be based on the latest developments in causal inference, in particular, exploring new matching and weighting techniques when appropriate.The research here proposed will be expanded in two possible ways: first, by providing inputs to SARG, and second, by exploring longitudinal datasets which combine smoking behaviour with other unhealthy lifestyle behaviours such as alcohol misuse, unhealthy diet and sedentarism as contained in the Born in Bradford Study (BiB). By providing inputs to SARG, this research will enable the exploration of further health and economic costs associated to smoking behaviour dynamics, and create specific models for individuals, households, birth cohorts and local authority districts to have a holistic comprehension of smoking as a social, health and economic behaviour. By exploring BiB this research will study the relation between smoking behaviour dynamics at a household level and other unhealthy behaviours in the context of a specific cohort that has been followed since pregnancy.