Modeling the public health impact of a flavored cigar ban

摘要：项目3 该项目的目标是评估联邦香料雪茄禁烟对公众健康的影响。 在美国的使用、死亡率和健康差距。该项目将建立一个微观模拟模型 居住在美国、现在、以前或潜在的雪茄、香烟和电子烟使用者。 该模型可以用来跟踪一段时间内烟草的使用情况，因此加香雪茄禁令对吸烟和 美国人口和控烟重点人群的死亡率，例如 黑人或收入较低的人，可以估计。微观仿真模型将分三个阶段建立 与特定的目标相对应。具体地说，使用具有全国代表性的、纵向的 烟草与健康研究的人口评估，我们将估计烟草使用转变的概率 时间，重点是雪茄的使用对烟草产品的开始、停止和双重/复合使用的影响 (目标1)。我们将进行一项系统的审查，以汇编在饮用加香雪茄后使用雪茄的数据。 并从烟草专家那里获得潜在的政策设计效果。烟草专家将被要求开发出 合理和独特的雪茄禁烟情景来模拟和比较，并量化关键的禁令后 背景因素(例如，政策执行)影响禁令的影响(目标2)。最后，使用来自 目标1和2，并从文献中估计，我们将建立一个微观模拟模型来估计烟草如何 在联邦调味雪茄禁令和看似合理的节制下，雪茄的使用和死亡率发生变化 在某些情况下，如烟草零售商对禁令的遵守不力(目标3)。该项目将提供一个 全面了解加香雪茄禁令对公众健康的潜在影响，关键科学 反击可能对联邦禁令提出法律挑战的证据。我们还将确定政策面临的主要威胁 食品和药物管理局(FDA)与当地政府合作监测和解决的有效性 以及国家合作伙伴，以最大限度地实现该政策对公众健康的好处。该项目涉及FDA的研究 评估烟草产品特性(即风味)对开始和停止的影响的优先事项 (行为，目标1)，并了解FDA可能对烟草使用采取的监管行动对公众健康的影响 行为与健康(影响分析，目标2和3)。北卡罗来纳大学(UNC)烟草中心 监管科学部(TCORS)在烟草监管和通信方面拥有深厚的专业知识。该中心的 综合主题是为烟草产品的有效监管和沟通建立科学 不成比例地被优先人群使用--加味烟草产品。

ABSTRACT: PROJECT 3 The objective of this project is to estimate the public health impact of a federal flavored cigar ban on tobacco use, mortality and health disparities in the United States. This project will build a microsimulation model of individuals living in the US who are current, former, or potential users of cigars, cigarettes and e-cigarettes. The model can be used to track tobacco use over time, so the impact of a flavored cigar ban on smoking and mortality in the US population and in priority populations for tobacco control, such as among people who are Black or have lower incomes, can be estimated. The microsimulation model will be built in three phases corresponding to the specific aims. Specifically, using data from the nationally representative, longitudinal Population Assessment of Tobacco and Health study, we will estimate tobacco use transition probabilities over time, with a focus on the effects of cigar use on initiation, cessation, and dual/poly use of tobacco products (Aim 1). We will conduct a systematic review to compile data on cigar users’ tobacco use after a flavored cigar ban and elicit potential policy design effects from tobacco experts. Tobacco experts will be asked to develop plausible and distinct flavored cigar ban scenarios to simulate and compare, and quantify how key post-ban contextual factors (e.g., policy enforcement) affect the impact of the ban (Aim 2). Finally, using findings from Aims 1 and 2, and estimates from the literature, we will build a microsimulation model to estimate how tobacco use and mortality changes in the presence of a federal flavored cigar ban and in plausible moderating circumstances, such as with weak tobacco retailer compliance with a ban (Aim 3). This project will provide a comprehensive understanding of the potential public health impact of a flavored cigar ban, critical scientific evidence to counter likely legal challenges against a federal ban. We will also identify key threats to policy effectiveness for the Food and Drug Administration (FDA) to monitor and address in collaboration with local and state partners to maximize the public health benefits of the policy. This project addresses FDA research priorities to assess the impact of tobacco product characteristics (i.e., flavors) on initiation and cessation (Behavior, Aim 1) and to understand the public health impact of potential FDA regulatory action on tobacco use behavior and health (Impact Analysis, Aims 2 and 3). The University of North Carolina (UNC) Tobacco Centers of Regulatory Science (TCORS) has deep expertise in tobacco regulation and communications. The Center’s Integrative Theme is building the science for effective regulation of and communication about tobacco products disproportionately used by priority populations – flavored tobacco products.