Exploring scenarios to dramatically reduce smoking prevalence: a simulation model of the three-part cessation process.
OBJECTIVE
We used a simulation model to analyze whether the Healthy People 2010 goal of reducing smoking prevalence from the current 19.8% rate to 12% by 2010 could be accomplished by increasing quit attempts, increasing the use of treatments, or increasing the effectiveness of treatment.


METHODS
We expanded on previous versions of the tobacco control simulation model SimSmoke to assess the effects of an increase in quit attempts, treatment use, and treatment effectiveness to reduce smoking prevalence. In the model, we considered increases in each of these parameters individually and in combination.


RESULTS
Individually, 100% increases in quit attempts, treatment use, and treatment effectiveness reduced the projected 2020 prevalence to 13.9%, 16.7%, and 15.9%, respectively. With a combined 100% increase in all components, the goal of a 12% adult smoking prevalence could be reached by 2012.


CONCLUSIONS
If we are to come close to reaching Healthy People 2010 goals in the foreseeable future, we must not only induce quit attempts but also increase treatment use and effectiveness. Simulation models provide a useful tool for evaluating the potential to reach public health targets.
Levy
David T
DT
University of Baltimore, Baltimore, MD, USA. levy@pire.org
Mabry
Patricia L
PL
Graham
Amanda L
AL
Orleans
C Tracy
CT
Abrams
David B
DB
D000293:Adolescent; D000328:Adult; D000368:Aged; D003198:Computer Simulation; D005260:Female; D040361:Healthy People Programs; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000331:legislation & jurisprudence / Q000379:methods*; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology; D055815:Young Adult
MMWR Morb Mortal Wkly Rep. 2008 Nov 14;57(45):1226-8
19008791
Arch Intern Med. 2003 Oct 27;163(19):2337-44
14581254
Am J Prev Med. 2007 Dec;33(6 Suppl):S340-8
18021909
Tob Control. 1999 Autumn;8(3):323-6
10599578
Nicotine Tob Res. 2005 Jun;7(3):387-96
16085506
Soc Sci Med. 2005 May;60(10):2351-8
15748682
Tob Control. 2007 Dec;16 Suppl 1:i3-8
18048627
Am J Public Health. 2006 Mar;96(3):494-8
16449585
Nicotine Tob Res. 2005 Aug;7(4):491-9
16085520
Health Psychol. 1992;11(5):331-4
1425551
Tob Control. 1997;6 Suppl 2:S44-8
9583652
Milbank Q. 2008 Dec;86(4):601-27
19120982
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001007
15846610
Addict Behav. 2008 Dec;33(12):1516-20
18706769
MMWR Morb Mortal Wkly Rep. 2008 Nov 14;57(45):1221-6
19008790
Nicotine Tob Res. 2003 Apr;5(2):237-43
12745497
Am J Epidemiol. 1998 Aug 1;148(3):249-58
9690361
Risk Anal. 2005 Aug;25(4):801-12
16268930
Med Decis Making. 1993 Oct-Dec;13(4):322-38
8246705
J Policy Anal Manage. 2004 Aug;23(4):857-72
15499707
Expert Rev Pharmacoecon Outcomes Res. 2003 Aug;3(4):457-68
19807456
Am J Public Health. 2000 Aug;90(8):1311-4
10937017
Health Care Manag Sci. 2002 Apr;5(2):113-20
11993746
Addiction. 2005 Oct;100(10):1526-36
16185214
Am J Public Health. 2004 Feb;94(2):251-2
14759934
Med Care. 2001 Oct;39(10):1131-41
11567175
J Natl Cancer Inst. 1997 Apr 16;89(8):572-6
9106646
Am J Public Health. 2006 Mar;96(3):452-8
16449591
Am J Prev Med. 2010 Mar;38(3 Suppl):S364-72
20176309
J Health Care Poor Underserved. 2007 Nov;18(4 Suppl):52-72
18065852
Am J Health Promot. 2006 Mar-Apr;20(4):272-81
16555801
Am J Prev Med. 2010 Mar;38(3 Suppl):S373-81
20176310
Am J Public Health. 2004 Feb;94(2):205-10
14759928
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001292
15846616
Drug Alcohol Rev. 2006 Jan;25(1):59-71
16492578
Cochrane Database Syst Rev. 2004;(3):CD000146
15266423
Tob Control. 2003 Mar;12(1):21-7
12612357
Am J Prev Med. 2005 Jan;28(1):119-22
15626567
MMWR Morb Mortal Wkly Rep. 2007 Nov 9;56(44):1157-61
17989644
Addiction. 2004 Jan;99(1):29-38
14678060
Prev Med. 2000 Sep;31(3):279-86
10964642
MMWR Morb Mortal Wkly Rep. 2002 Jul 26;51(29):642-5
12186222
Med Decis Making. 2002 Jan-Feb;22(1):6-17
11833665
Am Psychol. 1989 Nov;44(11):1355-65
2589730
Tob Control. 1999 Autumn;8(3):261-5
10599569
Am J Public Health. 2005 Jun;95(6):1050-5
15914832
J Epidemiol Community Health. 2003 Oct;57(10):802-8
14573586
Prev Med. 2005 Jul;41(1):276-83
15917022
J Clin Epidemiol. 1990;43(12):1399-405
2254778
Cancer Causes Control. 2005 May;16(4):359-71
15953978
Tob Control. 2002 Mar;11(1):47-54
11891368
Cochrane Database Syst Rev. 2007 Jan 24;(1):CD000031
17253443