Project 1: The Impact of Changing Tobacco Product Use on Tobacco-Relate p167-193

FDA发布的任何烟草产品法规的一个重要组成部分是对烟草产品的经济分析， 规则。与吸烟有关的健康经济成本模型已经发展和改进 多年来，目前的模型考虑到吸烟、健康和 医疗支出。然而，缺乏对使用药物引起的医疗保健费用的研究。 烟草制品，除了香烟。鉴于利率上升， 哪些非卷烟产品正在使用。为了填补这一空白，我们建议开发模型来估计 因使用不同烟草产品而产生的医疗保健成本（即医疗保健支出），包括 雪茄、湿鼻烟、咀嚼烟草、薄荷醇和非薄荷醇香烟，这些产品的组合， 和二手烟暴露。具体而言，我们计划使用来自国家调查的个人层面数据， 1)开发微观经济模型，以估计可归因于使用不同的医疗保健成本 烟草产品，以确定该种产品是否会对成本产生重大影响，2）开发 微观经济模型来估计二手烟暴露造成的医疗费用。这些 模型将使我们能够评估潜在的FDA法规对医疗保健成本的影响， 使用三种替代方法预测烟草制品使用和二手烟暴露的变化 方法（利用国家调查数据进行时间序列分析，利用PATH进行纵向模式分析 数据，以及模拟烟草产品使用流行率的变化）并通过数学结合 肺和心血管疾病短期风险的模拟模型。我们的模型将结合 其他TCORS项目的结果，包括nsk感知对不同烟草使用的影响 烟草制品在年轻人和老年人中的影响，以及烟草制品对肺损伤的影响的研究 和心血管疾病。有了更好的吸烟成本模型和 与使用其他烟草产品相关的成本将有助于烟草产品的监管 因为政策分析需要考虑法规对烟草消费的影响， 成本 相关性（参见说明）： 我们将首次对与使用薄荷醇相关的医疗保健成本进行估算 香烟、雪茄、湿鼻烟和嚼烟以及更新和改进的成本估算 吸烟和接触二手烟的风险。我们将使用个人层面的微观经济成本 该模型框架改进了FDA以前使用的经济模型。模型还可以 用于评估影响烟草制品使用的其他政策对医疗保健支出的影响。

An important component of any regulation of tobacco products the FDA issues is an economic analysis of the regulation. Models of the health-related economic costs of cigarette smoking have evolved and improved over the years, and current models take into account the complex relationship between smoking, health, and healthcare expenditures. However, there is a lack of research on healthcare costs attributable to the use of tobacco products other than cigarettes. It is important to have this information given the increased rates at which non-cigarette products are being used. To fill this gap, we propose to develop models to estimate the healthcare costs (i.e. healthcare expenditures) resulting from the use of different tobacco products, including cigars, moist snuff, chewing tobacco, menthol and nonmenthol cigarettes, combinations of these products, and secondhand smoke exposure. Specifically, we plan to use individual level data from national surveys to 1) develop microeconomic models to estimate the healthcare costs attributable to the use of different tobacco products to determine whether the kind of product substantially affects costs and 2) develop microeconomic models to estimate the healthcare costs attributable to secondhand smoke exposure. These models will allow us to evaluate the impact of potential FDA regulations on healthcare costs through the projected changes in tobacco product use and secondhand smoke exposure using three alternative approaches (time senes analysis with data from national surveys, longitudinal model analysis with the PATH data, and simulated changes in tobacco product use prevalence) and through incorporating mathematical simulation models of short-term risks of pulmonary and cardiovascular diseases. Our models will incorporate findings from other TCORS projects, including the impact of nsk perception on use of different tobacco products among young adults and older adults, and studies ofthe effects of tobacco products on lung injury and cardiovascular disease in the short-term. Having better models ofthe cost of smoking and models of costs associated with the use of other tobacco products will be useful for the regulation of tobacco products because policy analysis needs to consider the impact of regulations on tobacco consumption as well as costs. RELEVANCE (See instructions): We will develop, for the first time, estimates of the healthcare costs associated with the use of menthol cigarettes, cigars, moist snuff, and chewing tobacco as well as updated and improved estimates ofthe cost of cigarette smoking and secondhand smoke exposure. We will use an individual-level microeconomic cost model framework that improves upon the economic model used previously by the FDA. The models also can be used to evaluate the impact on healthcare expenditures of other policies that impact tobacco product use.