MODELING THE POLICY IMPACT OF CIGARETTE AND SMOKELESS USE ON US MORTALITY

产品说明：FDA最近被赋予更广泛的权力，以规范任何新的或现有的烟草产品的生产，产品标准，营销和分销，以保护公众健康。关于这方面的研究很少。 FDA正在考虑的营销和产品法规对卷烟和无烟烟草的单一和双重用途的影响。在这些情况下，建模提供了一个“虚拟实验室”，可以综合现有证据，比较多项法规对美国烟草相关死亡的影响。在这个建议中，我们对过渡进行统计分析， 以及香烟和无烟烟草的使用。统计分析将考虑政策对开始、停止、多种产品使用和吸烟量的影响。我们将对三个现有模型进行统计分析，SimSmoke烟草控制政策模型和两个疾病自然史模型，密歇根州的里根-弗雷德哈钦森和马萨诸塞州总医院肺癌政策模型（LCPM）。这些模型是作为国家癌症研究所癌症干预和监测建模网络（CISNET）的一部分开发的。CISNET的一个关键进步是协同使用多个模型，通过共享输入来解决一个共同的问题，这是一种被引用为最佳建模实践的方法。SimSmoke、Michigan和LCPM模型将应用于美国。除了这些模型，我们还将为明尼苏达州和肯塔基州这两个政策结构非常不同的州开发SimSmoke模型，以评估FDA法规的影响如何根据州政策而变化。开发的模型将具有纳入新数据的能力和灵活性（例如，（如有必要，请参阅PATH研究）。SimSmoke、Michigan和LCPM模型将预测无烟烟草和香烟的使用，包括多种产品的使用以及产品之间的开始、停止和转换。我们将比较与FDA当局特别相关的法规对美国人群的影响：健康警告、零售点销售限制和产品内容监管。这些模型将考虑FDA法规对人口无烟烟草和卷烟流行率（总体和按年龄和性别）以及烟草所致死亡的影响。

DESCRIPTION: The FDA has recently been given broader authority to regulate the manufacture, product standards, marketing, and distribution of any new or existing product made or derived from tobacco in order to protect the public health. There is little research on the effects of marketing and product regulations being considered by the FDA on the sole and dual use of cigarettes and smokeless tobacco. In these situations, modeling provides a "virtual laboratory" to synthesize existing evidence and compare the impact of multiple regulations on US tobacco- related deaths. In this proposal, we conduct statistical analyses of the transitions to and from cigarette and smokeless tobacco use. The statistical analyses will consider the effect of policies on the initiation, cessation, multiple product use and quantity smoked. We will apply the statistical analyses to three existing models, the SimSmoke tobacco control policy model and two natural history of disease models, the Michigan-Fred Hutchinson (Michigan) and the Massachusetts General Hospital Lung Cancer Policy Model (LCPM) models. These models were developed as part of the National Cancer Institute's Cancer Intervention and Surveillance Modeling Network (CISNET). A key advance in CISNET has been the collaborative use of multiple models to address a common question using shared inputs, an approach cited for best modeling practices. The SimSmoke, Michigan and LCPM models will be applied to the US. In addition to these models, we will develop SimSmoke models for two states with very different policy structures, Minnesota and Kentucky, to gauge how the effects of FDA regulations may vary depending on state policies. The models will be developed with the capacity and flexibility to incorporate new data (e.g., the PATH study) as it becomes available. The SimSmoke, Michigan and LCPM models will project smokeless tobacco and cigarette use, incorporating multiple product use and the initiation, cessation, and switching between products. We will compare the US population impact of regulations particularly relevant to FDA authority: health warnings, retail point-of-sale restrictions and the regulation of product content. The models will consider the impact of FDA regulations on population smokeless tobacco and cigarette prevalence (in total and by age and gender) and on tobacco- attributable deaths.