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Estimating the Health Impacts of Tobacco Harm Reduction Policies: A Simulation Modeling Approach

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  • Sajjad Ahmad
  • John Billimek

Abstract

With adult smoking prevalence rates declining too slowly to reach national objectives, opinion leaders are considering policies to improve tobacco‐related outcomes by regulating the composition of cigarettes to be (1) less harmful and/or (2) less addictive. Because harm reduction efforts may actually encourage higher cigarette consumption by promoting a safer image, and addictiveness reduction may increase the harmfulness of cigarettes by encouraging compensatory smoking behaviors, policymakers must consider the tradeoffs between these two approaches when proposing legislation to control cigarette content. To estimate health impacts, we developed a dynamic computer model simulating changes in the age‐ and gender‐specific smoking behaviors of the U.S. population over time. Secondary data for model parameters were obtained from publicly available sources. Population health impacts were measured as change in smoking prevalence and the change in cumulative quality‐adjusted life‐years (QALYs) in the U.S. population over 75 years. According to the risk‐use threshold matrix generated by the simulation, modifying cigarettes to reduce their harmfulness and/or addictiveness could result in important gains to the nation's health. Addictiveness reduction efforts producing a 60% improvement in smoking behavior change probabilities would produce a net gain in population health at every plausible level of increase of smoking‐related harm that was modeled. A 40% reduction in smoking‐related harm would produce a net QALY gain at every level of behavior change considered. This research should prove useful to policymakers as they contemplate giving the FDA the authority to regulate the composition of cigarettes.

Suggested Citation

  • Sajjad Ahmad & John Billimek, 2005. "Estimating the Health Impacts of Tobacco Harm Reduction Policies: A Simulation Modeling Approach," Risk Analysis, John Wiley & Sons, vol. 25(4), pages 801-812, August.
  • Handle: RePEc:wly:riskan:v:25:y:2005:i:4:p:801-812
    DOI: 10.1111/j.1539-6924.2005.00647.x
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    References listed on IDEAS

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    1. Ahmad, Sajjad, 2005. "Closing the youth access gap: The projected health benefits and cost savings of a national policy to raise the legal smoking age to 21 in the United States," Health Policy, Elsevier, vol. 75(1), pages 74-84, December.
    2. Mendez, D. & Warner, K.E., 2000. "Smoking prevalence in 2010: Why the healthy people goal is unattainable," American Journal of Public Health, American Public Health Association, vol. 90(3), pages 401-403.
    3. Tammy O. Tengs & Sajjad Ahmad & Rebecca Moore & Eric Gage, 2004. "Federal policy mandating safer cigarettes: A hypothetical simulation of the anticipated population health gains or losses," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 23(4), pages 857-872.
    4. Adam Gifford Jr., 1999. "The Unintended Consequences of Regulating Addictive Substances," Cato Journal, Cato Journal, Cato Institute, vol. 19(2), pages 301-311, Fall.
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    Cited by:

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    2. John Hamer Powell & Michael Hammond & Albert Chen & Navonil Mustafee, 2018. "Human Agency in Disaster Planning: A Systems Approach," Risk Analysis, John Wiley & Sons, vol. 38(7), pages 1422-1443, July.

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