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，仍有760万烟民，英国最新的统计数据显示，有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。本研究建议通过使用一种新的概念和方法，即动态方法，来扩大我们对吸烟趋势的理解。这种方法通过时间的反复观察，可以研究随时间的变化。在吸烟行为方面，这将需要从健康、经济和政策角度研究吸烟状态之间和内部的过渡和持续以及决定这一点的因素，以及其后果。本文提出的研究将使用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生命过程中吸烟决策的作用；2)文化规范、风险态度和风险偏好在吸烟代际传播中的作用；3)出生队列（或同伴互动）对吸烟行为的作用，以扩大我在SARG所做的工作，以及4)通过研究英国地方政府区一级的吸烟行为观察到的吸烟状态之间和吸烟状态内的过渡和持久性，空间的作用。由于吸烟越来越集中于特定的人群亚群，本研究建议在实证模型中加入亚群分析。要探讨的主要子群体是性别、社会经济地位和有心理健康问题的人口，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久性，以及总体上的吸烟不平等。只有当观察的数量允许我们这样做时，才会进行亚组分析。吸烟行为的研究不能孤立于英国在过去四十年中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、家庭和总体社会群体吸烟行为动态的影响。对于使用个人水平数据的政策评估模型，本研究将需要考虑到个人在其一生中可以在吸烟状态之间转换的事实，从而探索使用吸烟状态作为时变暴露的方法。政策分析将根据因果推理的最新发展，特别是酌情探索新的匹配和加权技术。这里提出的研究将以两种可能的方式扩展：第一，通过向SARG提供输入，第二，通过探索纵向数据集，将吸烟行为与其他不健康的生活方式行为（如酒精滥用、不健康饮食和久坐不动）结合起来，如出生在布拉德福德研究（BiB）中所包含的。通过向特别行政区政府提供投入，这项研究将能够进一步探索与吸烟行为动态有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建立具体模型，以便全面了解吸烟作为一种社会、健康和经济行为。通过探索BiB，本研究将研究家庭层面的吸烟行为动态与怀孕以来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.