Modeling the impact of tobacco regulations on US future trends of Chronic Obstructive Pulmonary Disease.

项目总结 此应用程序旨在为我提供指导体验、培训和访问资源 从专家模特小组，将使我实现我的长期职业目标，成为一个独立的 具有为烟草监管政策进行人口模拟建模科学的专业知识的调查员 基于系统思维的方法。我计划的培训和研究活动将由我的 导师David T Levy博士和Rafael Meza博士，烟草模拟建模领域的知名专家 和监管科学，以及一组专家合作者，旨在：增加我对以下方面的知识 肺部疾病的病理生理学、流行病学及其与烟草的关系 呼吸系统疾病(如慢性阻塞性肺疾病COPD)；掌握技术技能 烟草监管影响分析仿真建模的开发与实现 政策；并开发将烟草模拟建模结果转换为 通知政策。本研究项目的目的是建立一个COPD自然病程模型，基于 个人吸烟(香烟使用)历史，这将被用来预测两个人的长期人口影响 FDA烟草监管行动对COPD疾病负担的影响。慢性阻塞性肺病是发病的主要原因之一。 以及美国的死亡率。大多数慢性阻塞性肺病病例可以通过减少吸烟来预防。 然而，目前尚不清楚紧急法规对近期卷烟使用行为和 慢性呼吸道疾病，如慢性阻塞性肺病。了解烟草对健康的长期呼吸道影响 产品是FDA-烟草产品中心(CTP)的最高优先事项之一。这项研究将产生 使用公共卫生标准，证明以香烟为导向的控制政策对慢性阻塞性肺疾病的影响 告知FDA烟草法规的趋势。该项目有三个目标。目标1：确定 吸烟行为对肺功能和COPD死亡率影响的纵向变化：马尔科夫模型 分析。使用COPDgene队列的数据，我将评估吸烟行为的变化如何影响 烟草相关性COPD患者的肺功能下降和死亡率。目标2发展慢性阻塞性肺病自然病史 评估未来COPD发病率、患病率和COPD的微观模拟模型(COPD-NHM) 相关的呼吸系统和肺癌死亡取决于个人吸烟史(基线情景)。 目的3.在FDA的两种烟草监管方案下预测美国未来COPD的潜在趋势。这个 经过验证的COPD-NHM将用于评估1.香烟包装的健康状况对人口的影响 警告和2.薄荷醇香烟禁止COPD发病率和死亡率。拟议的研究将导致 提交R01裁决，将COPD-NHM扩大到包括其他非卷烟产品，以及其他 相关的行为、社会人口学和生物学特征，以涵盖以下各种方式 新的烟草或END监管政策可能会影响COPD和COPD相关癌症的进展。

PROJECT SUMMARY This application is designed to provide me with the mentoring experience, training and access to resources from expert modeling groups that will allow me to achieve my long-term career goal to become an independent investigator with expertise in conducting population simulation modeling science for tobacco regulatory policy based on a systems thinking approach. My planned training and research activities will be guided by my mentors, Drs. David T Levy and Rafael Meza, well-known experts in the area of tobacco simulation modeling and regulatory science, and a team of expert collaborators and are intended to: increase my knowledge about the pathophysiology of pulmonary diseases, epidemiology and association between tobacco and respiratory diseases (i.e. Chronic Obstructive Pulmonary Disease COPD); acquire technical skills for the development and implementation of simulation modeling for impact analysis of tobacco regulatory policies; and develop specialized knowledge in the translation of tobacco simulation modeling results to inform policies. The objective of this research project is to build a COPD natural history model based on individual smoking (cigarette use) histories, that will be used to predict the long-term population impact of two FDA tobacco regulatory actions on COPD disease burden. COPD is one of the principal causes of morbidity and mortality in the US. The majority of the COPD cases could be prevented by reducing cigarette use. However, it is not yet clear the long-term impact of emergent regulations on recent cigarette use behaviors and chronic respiratory diseases like COPD. Understanding the long-term health respiratory effects of tobacco products is one of the FDA-Center for Tobacco Products' (CTP) highest priority. This study will produce evidence, using a public health standard, about the impact of cigarette-oriented control policies on COPD trends to inform FDA tobacco regulations. The project has three aims. Aim 1: Determining the impact of longitudinal changes in smoking behavior on lung function and COPD mortality: a Markov Model Analysis. Using data from the COPDGene cohort, I will assess how changes in smoking behaviors impact the lung function decline and mortality of tobacco associated COPD. Aim 2 Develop a COPD Natural History microsimulation model (COPD-NHM) to estimate the future COPD incidence, prevalence and COPD associated respiratory and lung cancer deaths dependent on individual smoking histories (baseline scenario). Aim 3. Predict potential US future trends in COPD under two FDA tobacco regulatory scenarios. The validated COPD-NHM will be used to estimate the population impact of 1. cigarette pack graphic health warnings and 2. menthol cigarettes ban on COPD morbidity and mortality. The proposed research will lead to the submission of an R01 award to expand the COPD-NHM to include other non-cigarette products, and other relevant behavioral, sociodemographic and biological characteristics to encompass the various ways in which novel tobacco or ENDS regulatory policies could impact COPD and COPD associated cancer progression.