Modeling the public health impact of a national menthol cigarette ban.

项目摘要/摘要 在美国，吸烟是可预防的疾病和死亡的主要原因。超过三分之一的 美国的吸烟者使用薄荷醇香烟。薄荷醇香烟尤其令人关注公共健康。 因为它们使青少年更容易开始吸烟，而且比非薄荷醇更难戒烟 香烟。此外，年轻人、低收入者和种族/民族使用薄荷醇香烟的比例不成比例。 少数族裔吸烟者。2011年，烟草制品科学咨询委员会(TPSAC)，国会 为向美国食品和药物管理局(FDA)提供建议而成立的授权委员会报告称， 市场上的薄荷醇香烟将有利于美国的公共健康。尽管TPSAC 结论，FDA并未禁止薄荷醇香烟。相反，FDA要求进行额外的研究，以 通知监管部门的行动。该项目的目标是使用微观模拟建模来估计 国家薄荷醇香烟禁令对烟草使用和烟草相关疾病的影响，特别是 心血管疾病(CVD)和烟草相关癌症。这项研究将告知潜在的FDA 对薄荷醇香烟的监管行动。该项目有三个目标。目标1识别香烟的轨迹 随着时间的推移，使用纵向的、具有全国代表性的调查数据。为了达到这个目的，我将使用马尔科夫 用于计算烟草使用行为(频率、强度、味道偏好)转移概率的链 时间到了。目的2系统回顾和荟萃分析研究薄荷醇香烟禁令的效果 关于烟草产品的使用。这将是第一次综述有关薄荷脑影响的文献。 禁烟，为微观模拟建模提供了关键信息。AIM 3构建了一个微观模拟模型 以评估国家薄荷醇香烟禁令对吸烟的影响， 心血管疾病和与烟草相关的癌症。我会用最好的流行病学数据建立模型的参数 并进行敏感性分析，检验模型的有效性。最后，我会估计一下 吸烟、心血管疾病和烟草相关癌症将在总人口和特定人群中发生 如果实施薄荷醇香烟禁令，社会经济和种族/民族群体。我假设一个 国家薄荷醇香烟禁令将减少社会经济和种族/民族在吸烟、心血管疾病和 与烟草相关的癌症。职业发展奖将帮助我实现成为一名 独立的烟草控制和健康差距研究员。我将接受培训和指导 需要建立一个独立的研究计划，专注于烟草控制政策在 改善公众健康，特别是在吸烟和过度吸烟的人群中 与烟草有关的疾病。这项奖励最终将以申请R01拨款的形式结束，以扩大我的 微观模拟模型，比较额外的控烟政策对吸烟和疾病的影响。

PROJECT SUMMARY/ABSTRACT Smoking is the leading cause of preventable disease and death in the United States. More than one-third of smokers in the United States use menthol cigarettes. Menthol cigarettes are of particular public health concern because they make it easier for adolescents to initiate smoking and are more difficult to quit than non-menthol cigarettes. In addition, menthol cigarettes are disproportionately used by youth, low-income and racial/ethnic minority smokers. In 2011 the Tobacco Products Scientific Advisory Committee (TPSAC), a Congressionally mandated committee assembled to advise the Food and Drug Administration (FDA), reported that “removal of menthol cigarettes from the marketplace would benefit public health in the United States.” Despite TPSAC’s conclusion, the FDA has not banned menthol cigarettes. Instead, the FDA has requested additional research to inform regulatory action. The objective of this project is to use microsimulation modeling to estimate the impact of a national menthol cigarette ban on tobacco use and tobacco-related disease, specifically cardiovascular disease (CVD) and tobacco-related cancers. This research would inform potential FDA regulatory action on menthol cigarettes. The project has three aims. Aim 1 identifies trajectories of cigarette use over time using longitudinal, nationally representative survey data. To achieve this aim, I will use Markov chains to compute transition probabilities of tobacco use behavior (frequency, intensity, flavor preference) over time. Aim 2 systematically reviews and meta-analyzes studies examining the effects of menthol cigarette bans on tobacco product use. This will be the first review to synthesize the literature on the impact of a menthol cigarette ban, providing critical information for microsimulation modeling. Aim 3 builds a microsimulation model of smoking and tobacco-related disease to estimate the impact of a national menthol cigarette ban on smoking, CVD, and tobacco-related cancers. I will establish parameters for the model using the best epidemiological evidence and conduct sensitivity analyses to test the validity of the model. Finally, I will estimate the change in smoking, CVD, and tobacco-related cancers that would occur in the total population and in specific socioeconomic and racial/ethnic groups if a menthol cigarette ban were implemented. I hypothesize that a national menthol cigarette ban will reduce socioeconomic and racial/ethnic disparities in smoking, CVD, and tobacco-related cancers. The career development award will help me achieve my goal of becoming an independent tobacco control and health disparities researcher. I will receive the training and mentorship needed to build an independent research program focused on the role tobacco control policy may play in improving the public’s health, in particular among groups that disproportionately suffer from smoking and tobacco-related disease. This award will culminate in an application for an R01 grant to expand upon my microsimulation model, comparing the impacts of additional tobacco control policies on smoking and disease.