Novel microsimulation model of tobacco use behaviours and outcomes: calibration and validation in a US population

Author:

Reddy Krishna PORCID,Bulteel Alexander J B,Levy Douglas E,Torola Pamela,Hyle Emily P,Hou Taige,Osher Benjamin,Yu Liyang,Shebl Fatma M,Paltiel A David,Freedberg Kenneth A,Weinstein Milton C,Rigotti Nancy A,Walensky Rochelle P

Abstract

Background and objectiveSimulation models can project effects of tobacco use and cessation and inform tobacco control policies. Most existing tobacco models do not explicitly include relapse, a key component of the natural history of tobacco use. Our objective was to develop, calibrate and validate a novel individual-level microsimulation model that would explicitly include smoking relapse and project cigarette smoking behaviours and associated mortality risks.MethodsWe developed the Simulation of Tobacco and Nicotine Outcomes and Policy (STOP) model, in which individuals transition monthly between tobacco use states (current/former/never) depending on rates of initiation, cessation and relapse. Simulated individuals face tobacco use-stratified mortality risks. For US women and men, we conducted cross-validation with a Cancer Intervention and Surveillance Modeling Network (CISNET) model. We then incorporated smoking relapse and calibrated cessation rates to reflect the difference between a transient quit attempt and sustained abstinence. We performed external validation with the National Health Interview Survey (NHIS) and the linked National Death Index. Comparisons were based on root-mean-square error (RMSE).ResultsIn cross-validation, STOP-generated projections of current/former/never smoking prevalence fit CISNET-projected data well (coefficient of variation (CV)-RMSE≤15%). After incorporating smoking relapse, multiplying the CISNET-reported cessation rates for women/men by 7.75/7.25, to reflect the ratio of quit attempts to sustained abstinence, resulted in the best approximation to CISNET-reported smoking prevalence (CV-RMSE 2%/3%). In external validation using these new multipliers, STOP-generated cumulative mortality curves for 20-year-old current smokers and never smokers each had CV-RMSE ≤1% compared with NHIS. In simulating those surveyed by NHIS in 1997, the STOP-projected prevalence of current/former/never smokers annually (1998–2009) was similar to that reported by NHIS (CV-RMSE 12%).ConclusionsThe STOP model, with relapse included, performed well when validated to US smoking prevalence and mortality. STOP provides a flexible framework for policy-relevant analysis of tobacco and nicotine product use.

Funder

Massachusetts General Hospital

National Institute on Drug Abuse

National Heart, Lung, and Blood Institute

Publisher

BMJ

Subject

General Medicine

Reference66 articles.

1. 21st-Century Hazards of Smoking and Benefits of Cessation in the United States

2. Annual Healthcare Spending Attributable to Cigarette Smoking

3. US Department of Health and Human Services . The health consequences of smoking-50 years of progress: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. https://www.hhs.gov/surgeongeneral/reports-and-publications/tobacco/index.html

4. Tobacco product use and cessation indicators among adults - United States, 2018;Creamer;MMWR Morb Mortal Wkly Rep,2019

5. Underutilization of evidence-based smoking cessation support strategies despite high smoking addiction burden in peripheral artery disease specialty care: insights from the International portrait registry;Patel;J Am Heart Assoc,2018

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