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

项目总结/摘要 吸烟是美国可预防疾病和死亡的主要原因。超过三分之一 美国的吸烟者使用薄荷香烟。薄荷香烟是一个特别令人关注的公共卫生问题 因为它们使青少年更容易开始吸烟，并且比非薄荷醇更难戒烟 香烟此外，青年、低收入和种族/族裔的人不成比例地使用薄荷醇香烟。 少数吸烟者2011年，烟草制品科学咨询委员会（TPSAC）在国会 一个负责向食品和药物管理局（FDA）提供建议的授权委员会报告说， 市场上的薄荷香烟将有利于美国的公共健康。”尽管TPSAC的 因此，FDA并没有禁止薄荷香烟。相反，FDA要求进行额外的研究， 知情的管制行动。本项目的目标是使用微观模拟建模来估计 全国薄荷卷烟禁令对烟草使用和烟草相关疾病影响， 心血管疾病（CVD）和烟草相关癌症。这项研究将告知潜在的FDA 对薄荷香烟采取管制行动。该项目有三个目标。目标1识别香烟的轨迹 使用具有全国代表性的纵向调查数据。为了达到这个目的，我将使用马尔可夫 链来计算烟草使用行为（频率、强度、口味偏好）的转移概率， 时间目标2系统地回顾和荟萃分析研究了薄荷香烟禁令的影响 烟草产品使用。这将是第一次审查，以综合文献的影响，薄荷醇 香烟禁令，为微观模拟建模提供关键信息。AIM 3建立了一个微观仿真模型 吸烟和烟草相关疾病的影响，以估计全国薄荷卷烟禁令对吸烟的影响， CVD和烟草相关的癌症。我会用最好的流行病学方法建立模型的参数 并进行敏感性分析，以测试模型的有效性。最后，我将估计 吸烟、心血管疾病和烟草相关的癌症可能发生在总人口中， 如果实施薄荷香烟禁令，社会经济和种族/族裔群体将受到影响。我假设 国家薄荷醇香烟禁令将减少吸烟，心血管疾病， 与烟草有关的癌症职业发展奖将帮助我实现成为一名 独立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，重点是烟草控制政策可能发挥的作用， 改善公众的健康，特别是吸烟人数过多的群体的健康， 烟草相关疾病这个奖项将最终在申请R 01赠款，以扩大我的 微观模拟模型，比较额外的烟草控制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.