Effect of Tobacco Advocacy at the State Level

描述(由申请者提供)：烟草使用仍然是美国主要的可预防的死亡原因。高质量的积极烟草控制计划不仅可以预防烟草使用和疾病，而且可以成为医疗保健成本控制的重要组成部分，这是各级政府和私营部门的关键政策关切。在减少吸烟或节省每一美元的医疗保健成本方面，所有的烟草控制计划并不是同样有效。此外，烟草业努力阻止或削弱这些计划的有效性。该项目将使用定性和定量相结合的方法来实现三个具体目标：1.记录和分析烟草控制政策制定和计划执行方面的变化，包括在制定和实施烟草控制计划方面取得不同成功程度的州中不断演变的烟草行业战略，以作为制定最有效和最高效的烟草控制战略和政策的建议的基础。2.定义州控烟计划支出、吸烟和医疗保健支出之间的关系，并使用这些关系来量化计划强度和质量的影响。3.量化烟草控制政策对吸烟开始、进展和戒烟以及健康差距的影响。我们将通过一系列详细的案例研究州控烟政策和方案的发展和效果来实现目标1。我们将使用现代计量经济学方法(基于协整回归)实现目标2，以量化这些计划对吸烟行为的影响，进而量化吸烟对医疗保健成本的影响。对于目标2和目标3，我们将把国家数据集(全国青年纵向调查和当前人口调查的烟草使用补充资料)与清洁室内空气法、烟草税、价格和人口变量的政策数据合并，以开发新的吸烟行为模式，为了解这些政策如何影响个人行为和健康差距提供框架。由此产生的知识将增加成功制定和实施有效烟草控制政策的可能性，方法是向公共卫生官员和倡导者提供关于如何使计划有效性最大化的信息，并同样重要的是，了解如何确保卫生当局使用日益有限的资源来支持最有效的干预措施。

DESCRIPTION (provided by applicant): Tobacco use remains the nation's leading preventable cause of death. High quality aggressive tobacco control programs not only prevent tobacco use and disease, but can be an important component of health care cost containment, a key policy concern at all levels of government and in the private sector. All tobacco control programs are not equally effective in terms of reducing smoking or health care costs savings per dollar spent. In addition, the tobacco industry works to stop or blunt these programs' effectiveness. This project will use a combination of qualitative and quantitative methods to accomplish three Specific Aims: 1. Document and analyze the variations in tobacco control policymaking and program implementation, including evolving tobacco industry strategies, in states with varying levels of success at developing and implementing tobacco control programs, to serve as the basis for recommendations to create the most effective and efficient tobacco control strategies and policies. 2. Define the relationships between state tobacco control program spending, smoking, and health care expenditures and use these relationships to quantify the effects of program intensity and quality. 3. Quantify the effects of tobacco control policies on smoking initiation, progression and cessation, and health disparities. We will pursue Aim 1 through a series of detailed case studies of the development and effects of state tobacco control policies and programs. We will pursue Aim 2 using modern econometric methods (based on cointegrating regressions) to quantify the effects of these programs on smoking behavior and, in turn, the effects of smoking on health care costs. For Aims 2 and 3, we will merge national datasets (the National Longitudinal Survey of Youth and the Tobacco Use Supplement of the Current Population Survey) with policy data on clean indoor air laws, tobacco taxes, price and demographic variables to develop new models of smoking behavior that will provide a framework for understanding how these policies affect individual behavior and health disparities. The resulting knowledge will increase the likelihood of successfully developing and implementing effective tobacco control policies by providing information to public health officials and advocates on how to maximize program effectiveness and, equally important, understand how to ensure that health authorities use increasingly limited resources to support the most effective interventions.