About the Tobacco Control Policy tool

The TCP (Tobacco Control Policy) tool allows users to interactively examine the effects of different tobacco control policies using a policy simulation model. While the previous version of the TCP tool used results from a microsimulation model1, the new version of the TCP tool has been updated to use results from a population model.

The model draws upon existing research on the effects of tobacco policies on smoking behavior to simulate population health outcomes. The results compare smoking and mortality outcomes under a baseline scenario ('status quo') with those under your specified policy scenario. For the baseline 'status quo' scenario, the model assumes that current rates for smoking initiation and cessation remain constant for future birth cohorts. This policy model is an extension of the CISNET Smoking History Generator (SHG).

The Smoking History Generator (SHG) population model

All CISNET lung cancer models are based on inputs from the Smoking History Generator (SHG), which simulates detailed individual-level life and smoking histories: birth, and probabilities of smoking initiation, smoking cessation, and death. The SHG relies on a variety of data sources, including the National Health Interview Survey, to determine the probability that a never smoker becomes a smoker and that a smoker quits per year. These probabilities are specific to an individual’s gender, age, and year of birth. Mortality rates and the relative risks of death by smoking status are then used to generate the probability of death based on age, gender, birth cohort, and smoking status. From these individual simulations, the SHG is able to model smoking prevalence and deaths in the US population. More information about the Smoking History Generator inputs and their applications2-5 can be found on the CISNET Publication Support and Modeling Resources website.

The SHG population model simulates the effects of different tobacco control interventions by modifying underlying probabilities of smoking initiation and cessation. These modifiers account for different policy effects by age and for the tendency for the impact of a policy to decline over time. Note that the model only simulates the impact of a policy on smoking behavior, and does not consider the health benefits of reduced secondhand smoke exposure.

Policy scenarios simulate the potential impact of a specific policy on adult smoking prevalence, the number of life-years gained, and the number of deaths avoided. To date, the SHG population model has been developed for four types of tobacco control policies: smoke-free air laws, increasing cigarette taxes, raising the minimum age of legal access to tobacaco (MLA), and increasing the level of tobacco control program expenditures.

To make the TCP tool useful to decision-makers at the state level, model results have been scaled to approximate 1) the size of each state’s population according to population estimates from the Census Bureau, and 2) smoking rates within each state based on prevalence estimates from the Behavioral Risk Factor Surveillance System.

For more information about the development of the TCP tool, download our summary slides (PPT) and watch our webinar video.

References

  1. Tam J, Levy DT, Jeon J, Clarke J, Gilkeson S, Hall T, Feuer EJ, Holford TR, Meza R. Projecting the effects of tobacco control policies in the USA through microsimulation: a study protocol. BMJ Open 2018;8:e019169. doi: 10.1136/bmjopen-2017-019169. [BMJ Open]
  2. Jeon J, Jeon J, Holford TR, Levy DT, Feuer EJ, Cao P, Tam J, Clarke L, Clarke J, Kong CY, Meza R. Smoking and Lung Cancer Mortality in the United States From 2015 to 2065: A Comparative Modeling Approach. Ann Intern Med. 2018;169(10):684-693. [PubMed]
  3. Holford TR, Meza R, McKay LA, Clarke L, Racine B, Meza R, Land S, Jeon J, Feuer EJ. Patterns of birth cohort-specific smoking histories, 1965-2009. Am J Prev Med 2014;46(2):e31-7. [PubMed]
  4. Moolgavkar SH, Holford TR, Levy DT, Kong CY, Foy M, Clarke L, Jeon J, Hazelton WD, Meza R, Schultz F, McCarthy W, Boer R, Gorlova O, Gazelle GS, Kimmel M, McMahon PM, de Koning HJ, Feuer EJ. Impact of reduced tobacco smoking on lung cancer mortality in the United States during 1975-2000. J Natl Cancer Inst2012 Apr 4;104(7):541-8. Epub 2012 Mar 14. [PubMed]
  5. Jeon J, Meza R, Krapcho M, Clarke LD, Byrne J, Levy DT. Actual and counterfactual smoking prevalence rates in the U.S. population via microsimulation. Risk Anal. 2012;32:S51–S68. [PubMed]

About Us

The Tobacco Control Policy (TCP) tool is brought to you by the Lung Group of the Cancer Intervention and Surveillance Modeling Network (CISNET), a consortium of researchers developing computational models of smoking and lung cancer.

Researchers at the University of Michigan, Georgetown University, Yale University, Massachusetts General Hospital, Stanford University and Erasmus University collaborate and aim to quantify the impact of tobacco control policies on smoking, lung cancer, and mortality. The TCP tool is part of a broader CISNET research agenda to evaluate the potential impact of cancer control strategies on US populations.

The TCP tool uses inputs from the CISNET Smoking History Generator, which simulates individual life histories of smoking behavior. More information about the Smoking History Generator inputs and their applications can be found on the CISNET Publication Support and Modeling Resources website.

Principal Investigators

Rafael Meza, PhD, Department of Epidemiology, School of Public Health, University of Michigan

Jamie Tam, MPH, PhD, Department of Health Policy and Management, Yale School of Public Health

David Levy, PhD, Lombardi Comprehensive Cancer Center, Georgetown University

Jihyoun Jeon, PhD, Department of Epidemiology, School of Public Health, University of Michigan

Lisa Lau, MPH, Department of Epidemiology, School of Public Health, University of Michigan

Theodore Holford, PhD, Department of Biostatistics, Yale School of Public Health

Funding support

The research and development of the TCP tool was supported by National Cancer Institute of the National Institutes of Health under award numbers U01CA199284 and U01CA152956. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Development team

Cornerstone Systems Northwest: Website and data visualization

Scott Gilkeson: User research

Contact information

We welcome your comments, questions, and suggestions regarding the TCP tool. Please contact us at info@tobaccopolicyeffects.org.