title: Assessment of health impacts of decreased smoking prevalence in Copenhagen: Application of the DYNAMO-HIA model.
abstract: OBJECTIVE
  Tobacco smoking is among the leading risk factors for chronic disease and early death in developed countries, including Denmark, where smoking causes 14% of the disease burden. In Denmark, many public health interventions, including smoking prevention, are undertaken by the municipalities, but models to estimate potential health effects of local interventions are lacking. The aim of the current study was to model the effects of decreased smoking prevalence in Copenhagen, Denmark.
  
  
  METHODS
  The DYNAMO-HIA model was applied to the population of Copenhagen, by using health survey data and data from Danish population registers. We modelled the effects of four intervention scenarios aimed at different target groups, compared to a reference scenario. The potential effects of each scenario were modelled until 2040.
  
  
  RESULTS
  A combined scenario affecting both initiation rates among youth, and cessation and re-initiation rates among adults, which reduced the smoking prevalence to 4% by 2025, would have large beneficial effects on incidence and prevalence of smoking-related diseases and mortality. Health benefits could also be obtained through interventions targeting only cessation or re-initiation rates, whereas an intervention targeting only initiation among youth had marginal effects on morbidity and mortality within the modelled time frame.
  
  
  CONCLUSIONS
  By modifying the DYNAMO-HIA model, we were able to estimate the potential health effects of four interventions to reduce smoking prevalence in the population of Copenhagen. The effect of the interventions on future public health depended on population subgroup(s) targeted, duration of implementation and intervention reach.
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark asho@sund.ku.dk.
authors.forename: Astrid Ledgaard
authors.initials: AL
authors.lastname: Holm
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Brønnum-Hansen
authors.affiliation: Research Centre for Prevention and Health, Capital Region of Denmark, Denmark.
authors.forename: Kirstine Magtengaard
authors.initials: KM
authors.lastname: Robinson
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Diderichsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D061213:Mortality, Premature; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult
keywords: Disease modelling; effect modelling; health impact assessment; prevention; smoking; tobacco