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U of M TCORS Project 1: Comparative Modeling of the Impact of E-cigarettes use on Smoking and Long-Term Health Outcomes

Principal Investigator(s): David T. Levy, Theodore R. Holford, David Mendez and Rafael Meza

Funding Mechanism: National Institutes of Health – TCORS Grant

ID number: 1 U54 CA229974-01

Award Date: 9/14/18

Institution: Georgetown University, Yale University, and University of Michigan

The goal of this project is to use four established tobacco control simulation models to examine the impact of different possible FDA regulatory actions on future trends in cigarette and e-cigarette use and associated health outcomes. Study aims are: (1) to characterize differences in cigarette and e-cigarette use patterns and to monitor changes in use patterns over time; (2) to extend well-established simulation models so that they consider mortality from specific health outcomes, including lung cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and maternal and child health outcomes; (3) to project mortality from lung cancer, COPD, cardiovascular disease, and low birth weight births under current cigarette and e-cigarette use patterns (status quo); (4) to estimate the impact of past and potential new tobacco control policies on patterns of cigarette and e-cigarette use; and (5) to model the impact of past and potential new policies on all-cause mortality and health outcomes associated with cigarettes and e-cigarettes. Researchers will use a generalized decision analysis framework and statistical approaches to develop initial prevalence rates for the models, a range of plausible future status quo transitions by age and gender for initiation and cessation of cigarettes and e-cigarettes, and a range of plausible switching rates between cigarettes and e-cigarettes. Using literature reviews and expert elicitation panels, researchers will develop relative risk estimates for specific health outcomes, and then will project tobacco-related mortality due to cardiovascular disease, COPD, and adverse maternal and child health outcomes. Researchers will extend the models to project how specific potential regulatory activities (e.g., health warnings on cigarette packages; public education campaign) individually and in combination will likely impact cigarette and e-cigarette use rates and associated health outcomes over a 50-year future period. The models may be extended to consider other nicotine delivery products, including cigars, smokeless tobacco and heat-not-burn products. Results will provide evidence-based, expert-informed estimates of tobacco use prevalence, health outcomes, and policy impacts.

U of M TCORS: Center for the Assessment of the Public Health Impact of Tobacco Regulations Resources

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