PROJECT 5: IMPACT OF CHANGING TOBACCO PRODUCT USE ON HEALTHCARE COSTS FOR GENERAL AND VULNERABLE POPULATIONS

项目 5：改变烟草产品使用对普通人群和弱势群体医疗费用的影响

• 批准号: 10259841
• 负责人: WENDY B MAX
• 金额: $ 51.47万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-19 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10259841
• 关键词: Address; Adult; Attention; Behavior; Cardiovascular Diseases; Characteristics; Cigar; Cigarette; Cigarette Smoker; Communication; Data; Doctor of Philosophy; Econometric Models; Economic Models; Electronic cigarette; Emerging Tobacco Products; Funding; General Population; Goals; Health; Health Care Costs; Health Expenditures; Health Status; High School Student; Human; Individual; Laboratories; Laboratory Study; Lung diseases; Measures; Medical; Minority; Modeling; N' -nitrosonornicotine; National Health Interview Survey; Outcome; Pattern; Persons; Play; Population; Population Assessment of Tobacco and Health; Population Group; Public Health; Regulation; Research; Risk; Risk Behaviors; Role; Rural; Rural Population; Schools; Smokeless Tobacco; Smoking; Socioeconomic Status; Subgroup; Surveys; Time; Tobacco; Tobacco use; Update; Vulnerable Populations; Work; Youth; aged; base; behavioral economics; cigarette smoking; comorbidity; comparison group; cost; cost estimate; economic impact; electronic cigarette use; ethnic minority population; experience; health care service utilization; heated tobacco products; improved; interest; low socioeconomic status; polytobacco use; racial and ethnic; simulation; smokeless tobacco use; sociodemographics; tobacco products; tobacco user; young adult

PROJECT SUMMARY/ABSTRACT Healthcare costs play a central role in FDA regulatory impact analysis. Many factors contribute to tobacco- attributable healthcare costs, including changing tobacco product use patterns, sociodemographic characteristics, health status, and socioeconomic status (SES). The central goal of this project is to develop economic models that analyze the impact of new patterns of tobacco product use on healthcare costs for different populations including those that are particularly vulnerable. The project focuses on cigarette smoking, e-cigarette use, and polytobacco use as common tobacco use patterns today, and on rural/urban status, low SES, medical co-morbidities, and youth as examples of factors that cause population groups to be particularly vulnerable to tobacco use. The goal will be accomplished by addressing four specific aims: (1) Develop microeconomic models to estimate the healthcare costs attributable to e- cigarette use; (2) Estimate healthcare costs attributable to cigarette smoking and e-cigarette use for vulnerable populations: people with low SES, rural populations, people with medical co-morbidities, and youth; (3) Develop microeconomic models to estimate the healthcare costs attributable to the most common combinations of tobacco product use: dual use of cigarettes and e-cigarettes; dual use of cigarettes and cigars; and polyuse of cigarettes, e-cigarettes, and other tobacco products; and (4) Analyze potential scenarios to determine the likely impact of regulatory changes on healthcare costs based on findings from research conducted by UCSF TCORS colleagues in laboratory and controlled human studies. Tobacco-attributable healthcare costs will be estimated using econometric models and a factual/counterfactual approach, in which costs among users of the product(s) of interest (i.e., the factual case) are compared with costs among people with identical characteristics as the users except that they are assumed to be never tobacco users or sole cigarette smokers, depending on the relevant comparison group (i.e., the counterfactual case). This project addresses the UCSF TCORS theme that “understanding combined health effects, behavior, and impact analysis will provide actionable information for regulation of and public communications about current and emerging tobacco products” by developing economic models of the impact of tobacco use on health outcomes and healthcare costs and integrating health effects from laboratory and human studies in simulations of the impact on healthcare utilization and costs from changes in product characteristics and availability. The relationship of tobacco use behavior and lost school days among rural youth will also be modeled. This information is incorporated into economic models to improve impact analyses. The healthcare cost estimates from this project will be useful metrics for measuring the impact of tobacco use on public health, allowing a comparison of the relative magnitude of health effects of different tobacco products on specific populations.

项目总结/摘要 医疗成本在FDA监管影响分析中发挥着核心作用。许多因素导致烟草- 可归因的医疗保健成本，包括改变烟草产品使用模式，社会人口 特征、健康状况和社会经济地位（SES）。该项目的核心目标是 开发经济模型，分析烟草产品使用的新模式对 不同人群的医疗费用，包括特别脆弱的人群。项目 重点关注吸烟、电子烟使用和多种烟草的使用，这些都是当今常见的烟草使用模式， 以及农村/城市地位、社会经济地位低、医疗共病和青年等因素， 特别容易受到烟草使用影响的人群。这一目标将通过解决 四个具体目标：（1）开发微观经济模型，以估计可归因于电子医疗保健成本， （2）估计吸烟和使用电子烟对弱势群体造成的医疗保健成本 人群：低SES人群、农村人群、合并症人群和青年;（3） 开发微观经济模型，以估计可归因于最常见的医疗保健成本 烟草制品的组合用途：香烟和电子烟的双重用途;香烟和雪茄的双重用途; 以及香烟、电子烟和其他烟草产品的综合使用;以及（4）分析潜在的情景， 根据研究结果确定监管变化对医疗成本的可能影响 由UCSF TCORS同事在实验室和对照人体研究中进行。烟草归因 将使用计量经济学模型和事实/反事实方法估计医疗保健成本，其中 感兴趣的产品的用户之间的成本（即，事实情况）与人们之间的成本进行比较 与使用者具有相同的特征，除了他们被假设为从不吸烟或唯一吸烟者之外 吸烟者，取决于相关的对照组（即，反事实案件）。这个项目 解决了UCSF TCORS的主题，即“了解综合健康影响，行为和影响 分析将提供可操作的信息，用于监管和公共通信， 新兴烟草产品”的影响，开发烟草使用对健康结果的影响的经济模型， 和医疗保健成本，并将实验室和人类研究的健康影响纳入模拟 产品特性和可用性变化对医疗保健利用率和成本的影响。的 并建立农村青少年吸烟行为与失学天数的关系模型。这 信息被纳入经济模型，以改进影响分析。医疗保健费用估计 这一项目将成为衡量烟草使用对公共健康影响的有用指标， 比较不同烟草制品对特定人群健康影响的相对程度。