Integrating Longitudinal Data to Examine Directional, Synergistic and Differential Effects of Tobacco Control Policies on Smoking

摘要 尽管美国在降低吸烟率方面取得了重大进展， 美国人继续吸烟，吸烟仍然是这个国家可预防的主要死亡原因。 有证据表明，烟草控制政策，包括卷烟消费税、无烟空气法和 烟草控制计划的资金，可以有效地减少烟草消费的一般。剩下的 尚不清楚哪种烟草控制政策的组合最有效， 在政策紧缩期间可以维持，以及烟草政策是否可以大幅收缩 吸烟的社会经济差异。为了研究这些问题，我们建议开发和分析一个 数据集，将个人吸烟行为的纵向观察与状态和 地方烟草控制政策曝光率，以及社会经济状况的区域措施。使用重复 观察18，407个人的吸烟行为，因为他们所在的州，县或市的政策发生了变化，或者 当他们搬到一个有不同政策的新地方时，我们的目标是确定成年人吸烟的变化是否 暴露于更强有力的烟草控制政策后的行为与行为变化相反 在暴露于较弱的政策后观察，并评估哪些政策组合最有可能 在当前背景下有效。通过纳入个人和地区收入以及教育的措施， 我们的目标是进一步评估单一和综合烟草控制政策选择的影响， 吸烟的社会经济差异。我们的团队在多个领域拥有专业知识，包括烟草控制， 政策评估和纵向数据分析。这种创新的政策分析方法可以用来 对其他卫生相关政策的传统政策评价技术也是一种补充。

Abstract Although significant progress has been made in reducing smoking rates in the United States, one in seven Americans continues to smoke, and smoking remains the leading preventable cause of death in this country. Evidence suggests that tobacco control policies, including cigarette excise taxes, smokefree air laws and tobacco control program funding, can effectively reduce tobacco consumption in general. What remains unknown are which combinations of tobacco control policies are most effective, whether policy-related gains can be maintained during periods of policy retrenchment, and whether tobacco policies can shrink strong socioeconomic smoking disparities. To examine these questions, we propose to develop and analyze a dataset that integrates longitudinal observations of individual smoking behavior with measures of state and local tobacco control policy exposure, as well as area measures of socioeconomic status. Using repeated observations of 18,407 individuals' smoking behavior as policies change in their home state, county or city, or as they move to a new place with different policies, we aim to identify whether changes in adult smoking behavior following exposure to stronger tobacco control policies are the inverse of changes in behavior observed following exposure to weaker policies, and assess which policy combinations are most likely to be effective in the current context. By incorporating measures of individual and area income and educational status, we further aim to estimate the impact of single and combined tobacco control policy options on socioeconomic disparities in smoking. Our team has expertise in several areas, including tobacco control, policy evaluation and longitudinal data analysis. This innovative policy analysis method could be used to complement more traditional policy evaluation techniques for other health-related policies as well.