TCORS: Center for the Assessment of Tobacco Regulations (CAsToR)

Research Project 1: Modeling the Impact of Novel Tobacco Product use on Smoking and Long-Term Health Outcomes ​

In the past 10 years, the tobacco marketplace has dramatically changed in the US. US tobacco use patterns have changed dramatically due to regulations discouraging use of cigarette and other combustible products use, as well as the rapid evolution and marketing of novel nicotine and tobacco products. Project 1 will harmonize and extend well-established CAsToR tobacco simulation models to examine the impact of FDA regulatory actions on future trends in cigarette, cigar, ENDS, and other novel tobacco product use and associated health outcomes. This project will focus on Behavior (Aim 1), Impact Analysis (Aims 2 and 3) and Health Effects (Aims 2 and 3) as Scientific Domains (RFA-OD-22- 04). Project 1 has three aims:


  • Aim 1. Characterize longitudinal patterns of use and transitions of cigarettes, cigars, and novel nicotine products, individually and in combination. We will develop transition parameters between regular cigarette, ENDS, cigars, HTPs and ONPs to distinguish between exclusive, former, dual use and switching patterns for each product.
  • Aim 2. Develop simulation models of the use patterns of cigarettes, cigars, ENDS, and other tobacco products in the US and their health implications. We will expand the CAsToR simulation models (i.e., SimSmoke, Mendez and Warner, Microsimulation and SAVM) to incorporate product use, health outcomes and all-cause mortality risk of cigars, HTPs, and ONPs
  • Aim 3. Model the impact of existing and potential regulations on tobacco use patterns and all-cause mortality associated with cigarette, cigar, ENDS, and other novel tobacco.


  • Rafael Meza, PhD
    Rafael Meza, PhD
    British Columbia Cancer Research Institute
    Rafael Meza, PhD
    British Columbia Cancer Research Institute: Distinguished Scientist
    Positions: Administrative (ADMIN) Core; CAsToR Principal Investigator; Research Project 1; Research Project 4
    Dr. Meza is Principal Investigator of the Center for the Assessment of Tobacco Regulation (CAsToR) and the Coordinating Principal Investigator of the Cancer Intervention and Surveillance Modeling Network (CISNET) Lung Working Group. Prior to joining BC Cancer, Dr. Meza was Professor of Epidemiology and Global Health at the University of Michigan and co-Leader of the Cancer Control and Population Sciences of the Rogel Cancer Center. Dr. Meza is a Distinguished Scientist at the British Columbia Cancer Research Institute and Distinguished Scholar in Lung Cancer Screening and Prevention at the University of British Columbia. Dr. Meza's research interests lie at the interface of epidemiology, biostatistics and biomathematics. He is an expert in lung cancer epidemiology and prevention and tobacco epidemiology and control. The goal of his research program is to characterize the impact of disease prevention and control interventions, informing stakeholders and policymakers as to the most effective and efficient ways to improve population health. In particular, he is interested in cancer risk assessment and the analysis of cancer epidemiology data using mechanistic models of carcinogenesis. He is also interested in the mathematical modeling of chronic and infectious disease dynamics and its applications in disease prevention public health policy design.
  • David Levy, PhD
    David Levy, PhD
    Georgetown University
    David Levy, PhD
    Georgetown University: Professor, Georgetown University Medical Center
    Positions: Administrative (ADMIN) Core; CAsToR Principal Investigator; Research Project 1; Research Project 3
    Dr. David Levy is PI for CAsToR at Georgetown University. Dr. Levy received his PhD in Economics from UCLA (USA), and is currently a Professor of Oncology at Georgetown University. He has published over 250 articles, in renowned journals such as the American Economic Review, BMJ, AJPH, JAMA, The Lancet, Tobacco Control, and PLOS Medicine. He has been principal investigator of grants from the CDC, WHO, the National Cancer Institute, and Bloomberg/Gates Foundation. Dr. Levy currently oversees the design and development of the SimSmoke tobacco policy simulation model, for which he has developed models for over 40 countries covering 85% of the world’s population, and has recently developed models of smokeless tobacco and e-cigarette use. In addition to being a principal investigator on the TCORS grant, he is currently a principal investor on a National Cancer Institute grant with the International Tobacco Control Policy Evaluation Project (the ITC Project) in which he has developed models of e-cigarette use for Canada, England and France; and is a principal investigator on the National Cancer Institute CISNET Lung Group. He has recently published articles providing a public health framework for evaluating e-cigarettes and showing the potential benefits of e-cigarettes, as well as papers on the cigarette and e-cigarette markets.
  • Luz Sanchez Romero
    Luz Sanchez Romero
    Georgetown University
    Luz Sanchez Romero
    Georgetown University: Assistant Professor
    Position: Research Project 1
    Roles: Co-Investigator, New Investigator, Research Scientist
    Dr. Luz Sánchez Romero serves as a co-lead for Research Project 1. She is an Assistant Professor in the Department of Oncology at Georgetown University School of Medicine and a member of the Cancer Intervention and Surveillance Modeling Network (CISNET) Lung Working Group. Dr. Sánchez Romero research focuses on the development, adaptation and implementation of population simulation models, with the goal to assess the potential health impact of non-communicable diseases risk factor preventive policies. She is an expert in the epidemiology of risk factors such as tobacco and obesity and its impact on Chronic Obstructive Pulmonary Disease and Cardiovascular Disease at a national and international level. In particular, my interest lies in providing evidence-based and expert-informed modeling of the behavioral and public health impacts of tobacco regulations.