TCORS 2.0: Center for the Assessment of Tobacco Regulations (CAsToR)

Research Project 1: Comparative Modeling of the Impact of E-cigarettes use on Smoking and Long-Term Health Outcomes

Under the Family Smoking Prevention and Tobacco Control Act, the FDA is required to show that any new rule to regulate the marketing, sale or content of tobacco products is “appropriate for the protection of the public health.” To provide the FDA with a framework to assess the potential health impacts of tobacco regulations, this TCORS Project will harmonize and extend four established tobacco control simulation models to examine the impact of different possible FDA regulatory actions on future trends in cigarette and e-cigarette use, and associated health outcomes. The Project will focus on Impact Analysis (Aim 3, 4, and 5) and Health Effects (Aims 2 and 3), with a secondary emphasis on Behavior (Aim 1). Using a generalized harm reduction framework and statistical approaches to distinguish experimentation from long-term tobacco product use, we will develop initial prevalence rates for the models; a range of plausible future status quo transitions by age and gender for initiation and cessation for cigarettes and e-cigarettes; and a range of plausible switching rates between cigarettes and e-cigarettes. Using literature reviews and expert elicitation panels to develop relative risk estimates for specific health outcomes, we will extend the models from all-cause mortality to also project tobacco-related mortality due to cardiovascular and chronic obstructive pulmonary disease, and adverse maternal and child health outcomes. We will also extend the models to consider the impact of specific policies related to cigarette and e-cigarette use, such as the provision of information about health effects, using literature reviews and expert panels to develop policy effect estimates.

Aims

    Aim 1: To characterize differences in cigarette and e-cigarette use patterns and transitions and to monitor changes over time in use patterns
    Aim 2: To extend well-established simulation models so they can specifically project mortality from lung cancer, chronic obstructive pulmonary disease, cardiovascular disease, and maternal and child health outcomes
    Aim 3: To extend the models beyond projecting overall mortality to project mortality from lung cancer, chronic obstructive pulmonary disease, cardiovascular disease, and maternal and child health outcomes
    Aim 4: To estimate the impact of policies on patterns of cigarette and e-cigarette use
    Aim 5: To model the impact of existing and potential policies on all-cause mortality and health outcomes associated with cigarettes and e-cigarettes

Leads

  • Rafael Meza, PhDUniversity of Michigan
    Rafael Meza, PhD
    University of Michigan
    Rafael Meza, PhD
    University of Michigan: Associate Professor, Epidemiology; Associate Professor of Global Public Health; Co-Leader, Cancer Epidemiology and Prevention Program, UM Rogel Cancer Center
    Position: CAsToR Principal Investigator
    Profile: sph.umich.edu
    Dr. Rafael Meza is PI for CAsToR at the University of Michigan and co-Lead of Projects 1 - 2, as well as the Data Analysis and Dissemination Core. He is an Associate Professor of Epidemiology at the University of Michigan, as well as Co-Lead the Cancer Epidemiology and Prevention Program at the UM Rogel Cancer Center. His research utilizes mathematical modeling to assess risk of and develop screening tools for cancer. Dr. Meza has extensive experience in tobacco simulation modeling and has developed models as Coordinating PI for the Cancer Intervention and Surveillance Modeling Network (CISNET) lung group.
  • David Levy, PhDGeorgetown University
    David Levy, PhD
    Georgetown University
    David Levy, PhD
    Georgetown University: Professor, Georgetown University Medical Center
    Position: CAsToR Principal Investigator
    Dr. David Levy is PI for CAsToR at Georgetown University and co-Lead of Projects 1 - 3, and the Research Assessment and Input Development Core. He 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 InternationalTobaccoControl Policy Evaluation Project (theITCProject) 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.
  • David Mendez, PhDUniversity of Michigan
    David Mendez, PhD
    University of Michigan
    David Mendez, PhD
    University of Michigan: Associate Professor
    Positions: Core Lead, Career Enhancement Core (CEC); Project Lead, Research Project 2
    Role: Co-Investigator
    Profile: sph.umich.edu
    Dr. David Mendez is Core Lead for the Career Enhancement Core (CEC) and Project Lead for Research Project 2. He is also a member of the CAsToR Steering Committee. Dr. Mendez is an Associate Professor in the Department of Health Management and Policy at the University of Michigan. His research focuses on modeling trends of cigarette smoking cessation or switching to e-cigarettes. Dr. Mendez’s research also investigates the financial implications of these trends, with specific focus on tobacco control in the United States.
  • Theodore Holford, PhDYale University
    Theodore Holford, PhD
    Yale University
    Theodore Holford, PhD
    Yale University: Susan Dwight Bliss Professor of Public Health
    Positions: Core Lead, Data Analysis and Dissemination Core (DAD); Co-Investigator, Research Project 1; Co-Investigator, Research Project 2
    Role: Co-Investigator
    Dr. Theodore Holford is Project Lead of Data Analysis and Dissemination Core (DAD), Co-Investigator for Research Project 1, and Co-Investigator for Research Project 2, as well as a member of the CAsToR Steering Committee. He is the Susan Dwight Bliss Professor of Public Health at the Yale University School of Medicine, as well as a member of the Yale Cancer Center and Yale Institute for Global Health. Dr. Holford has worked extensively in methodology development, specifically to evaluate trends using age-period-cohort models and inform intervention strategies at the population level.