Modeling the impact of tobacco regulations on US future trends of Chronic Obstructive Pulmonary Disease.

项目摘要 此应用程序旨在为我提供指导经验，培训和资源访问 从专家建模组，这将使我实现我的长期职业目标，成为一个独立的 具有为烟草管制政策进行人口模拟建模科学专门知识的调查员 基于系统思维的方法。我计划的培训和研究活动将由我的 导师，大卫T利维和拉斐尔梅扎博士，在烟草模拟建模领域的知名专家 和监管科学，以及一个专家合作者团队，旨在：增加我对 肺疾病的病理生理学、流行病学以及烟草与 呼吸系统疾病（即慢性阻塞性肺疾病）;获得 烟草管制影响分析仿真模型的开发与实现 政策;并发展烟草模拟建模结果翻译的专业知识， 知情政策。本研究项目的目的是建立一个COPD自然病程模型， 个人吸烟（香烟使用）史，这将用于预测两个长期人口影响 FDA对COPD疾病负担的烟草监管行动。COPD是发病的主要原因之一 死亡率在美国。大多数COPD病例可以通过减少吸烟来预防。 然而，目前尚不清楚紧急法规对近期卷烟使用行为的长期影响， 慢性呼吸道疾病，如COPD。了解烟草对呼吸系统的长期健康影响 烟草制品是FDA烟草制品中心（CTP）的最高优先事项之一。这项研究将产生 使用公共卫生标准的证据，说明以药物为导向的控制政策对COPD的影响 FDA烟草法规的趋势。该项目有三个目标。目标1：确定 吸烟行为对肺功能和COPD死亡率影响的纵向变化：一个Markov模型 分析.使用来自COPDGene队列的数据，我将评估吸烟行为的变化如何影响 肺功能下降和死亡率。目的2：了解COPD自然史 用于估计未来COPD发病率、患病率和COPD的微观模拟模型（COPD-NHM） 依赖于个人吸烟史的相关呼吸道和肺癌死亡（基线情景）。 目标3.在两种FDA烟草监管情景下预测美国COPD的潜在未来趋势。的 经验证的COPD-NHM将用于估计1.香烟包装图案健康 警告和2。薄荷香烟禁止COPD发病率和死亡率。这项研究将导致 提交R 01奖，以扩大COPD-NHM，包括其他非卷烟产品，以及其他 相关的行为，社会人口和生物特征，包括各种方式， 新的烟草或ENDS监管政策可能会影响COPD和COPD相关癌症进展。

PROJECT SUMMARY This application is designed to provide me with the mentoring experience, training and access to resources from expert modeling groups that will allow me to achieve my long-term career goal to become an independent investigator with expertise in conducting population simulation modeling science for tobacco regulatory policy based on a systems thinking approach. My planned training and research activities will be guided by my mentors, Drs. David T Levy and Rafael Meza, well-known experts in the area of tobacco simulation modeling and regulatory science, and a team of expert collaborators and are intended to: increase my knowledge about the pathophysiology of pulmonary diseases, epidemiology and association between tobacco and respiratory diseases (i.e. Chronic Obstructive Pulmonary Disease COPD); acquire technical skills for the development and implementation of simulation modeling for impact analysis of tobacco regulatory policies; and develop specialized knowledge in the translation of tobacco simulation modeling results to inform policies. The objective of this research project is to build a COPD natural history model based on individual smoking (cigarette use) histories, that will be used to predict the long-term population impact of two FDA tobacco regulatory actions on COPD disease burden. COPD is one of the principal causes of morbidity and mortality in the US. The majority of the COPD cases could be prevented by reducing cigarette use. However, it is not yet clear the long-term impact of emergent regulations on recent cigarette use behaviors and chronic respiratory diseases like COPD. Understanding the long-term health respiratory effects of tobacco products is one of the FDA-Center for Tobacco Products' (CTP) highest priority. This study will produce evidence, using a public health standard, about the impact of cigarette-oriented control policies on COPD trends to inform FDA tobacco regulations. The project has three aims. Aim 1: Determining the impact of longitudinal changes in smoking behavior on lung function and COPD mortality: a Markov Model Analysis. Using data from the COPDGene cohort, I will assess how changes in smoking behaviors impact the lung function decline and mortality of tobacco associated COPD. Aim 2 Develop a COPD Natural History microsimulation model (COPD-NHM) to estimate the future COPD incidence, prevalence and COPD associated respiratory and lung cancer deaths dependent on individual smoking histories (baseline scenario). Aim 3. Predict potential US future trends in COPD under two FDA tobacco regulatory scenarios. The validated COPD-NHM will be used to estimate the population impact of 1. cigarette pack graphic health warnings and 2. menthol cigarettes ban on COPD morbidity and mortality. The proposed research will lead to the submission of an R01 award to expand the COPD-NHM to include other non-cigarette products, and other relevant behavioral, sociodemographic and biological characteristics to encompass the various ways in which novel tobacco or ENDS regulatory policies could impact COPD and COPD associated cancer progression.