Original Article

The Kentucky SimSmoke Tobacco Policy Simulation Model: Reaching Healthy People 2010 Goals Through Policy Change

Authors: David T. Levy, PhD, Cindy Tworek, PhD, MPH, Ellen J. Hahn, DNS, RN, RaeAnne E. Davis, MSPH

Abstract

Objectives: Healthy People (HP) 2010 has a goal of reducing adult smoking prevalence to 12% by 2010. Kentucky, with the highest adult smoking rates (28.7% versus a US average of 20.9%) and weak tobacco control policies, has the potential to reduce smoking by implementing stricter policies.


Methods: The SimSmoke tobacco control policy model is applied to Kentucky, validated over 1993 to 2003. Smoking prevalence evolves over time through initiation and cessation, as behaviors influenced by tobacco control policies.


Results: SimSmoke predicts well over the pre-2007 period, including larger annual decreases in latter years. With policies suggested by HP 2010 goals, smoking prevalence is projected to fall to about 19% by 2011 and 14% by 2026; more than 17,000 smoking-attributable deaths would be avoided by 2026.


Conclusions: SimSmoke suggests policies can have a large impact on smoking rates and save lives in Kentucky. If HP 2010 goals will be met, states such as Kentucky need to implement strong tobacco control policies.


Key Points


* Healthy People 2010 has set a goal of reducing adult smoking prevalence to 12% by the year 2010.


* In this validated SimSmoke model, a tested dynamic model of smoking trends, smoking prevalence evolves over time through initiation and cessation, which are influenced by tobacco control policies.


* Implementing policies consistent with Healthy People 2010 goals, smoking prevalence is projected to fall to about 19% by 2011 and 14% by 2026.


* SimSmoke suggests that stronger tobacco control policies can have a large impact on smoking rates and save lives in Kentucky.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. U.S. DHHS. Healthy People 2010. Atlanta, Centers for Disease Control, Office of Disease Prevention and Health Promotion, 2000.
 
2. CDC. Tobacco use among adults—United States, 2005. MMWR Morb Mortal Wkly Rep 2006;55:1145–1148.
 
3. CDC. State-specific prevalence of current cigarette smoking among adults and secondhand smoke rules and policies in homes and workplaces—United States, 2005. MMWR Morb Mortal Wkly Rep 2006;55:1148–1151.
 
4. CDC. Cigarette smoking before and after an excise tax increase and an antismoking campaign—Massachusetts, 1990–1996. MMWR Morb Mortal Wkly Rep 1996;45:966–970.
 
5. Levy D, Hyland A, Higbee C, et al. The role of public policies in reducing smoking prevalence in California: results from the California tobacco policy simulation model. Health Policy 2007;82:167–185.
 
6. Levy DT, Ross H, Powell L, et al. The role of public policies in reducing smoking prevalence and deaths caused by smoking in Arizona: results from the Arizona tobacco policy simulation model. J Public Health Manag Pract 2007;13:59–67.
 
7. Levy DT, Gitchell JG, Chaloupka F. The effects of tobacco control policies on smoking rates: a tobacco control scorecard. J Public Health Manag Pract 2004;10:338–351.
 
8. Chaloupka FJ, Hahn EJ, Emery SL. Policy levers for the control of tobacco consumption. KY Law J 2002;90:1009–1042.
 
9. Levy DT, Nikolayev N, Mumford EA. The healthy people 2010 smoking prevalence and tobacco control objectives: results from the SimSmoke tobacco control policy simulation model. Cancer Causes Control 2005;16:359–371.
 
10. Levy DT, Bauer JE, Lee HR. Simulation modeling and tobacco control: creating more robust public health policies. Am J Public Health 2006;96:494–498.
 
11. Levy DT, Nikolayev N, Mumford EA. Recent trends in smoking and the role of public policies: results from the SimSmoke tobacco control policy simulation model. Addiction 2005;10:1526–1537.
 
12. CDC. Annual smoking-attributable mortality, years of potential life lost and productivity losses—United States, 1997–2001. MMWR Morb Mortal Wkly Rep 2005;54:625–628.
 
13. Byerly E. Current Population Reports: National and State Population Estimates: 1990–1994. Census Bureau, 1995. Available at: http://www.census.gov/prod/1/pop/p25-1127.pdf. Accessed May 4, 2007.
 
14. Hamilton BE. National Vital Statistics Report. Center for Disease Control, 2003. Available at: http://www.cdc.gov/nchs/data/nvsr/nvsr51/nvsr51_12.pdf. Accessed May 4, 2007.
 
15. Technical Appendix from Vital Statistics of the United States: Mortality, 2001. Center for Disease Control, 2005. Available at: http://www.cdc.gov/nchs/data/statab/mortfinal2001_work23R.pdf. Accessed May 4, 2007.
 
16. Orzechowski W, Walker RC. The Tax Burden on Tobacco, Historical Compilation. Washington, DC, Orzechowski and Walker, 2006.
 
17. Legislation Files. Census Bureau. Available at: http://apps.nccd.cdc.gov/statesytem/. Accessed March 22, 2008.
 
18. Kentucky Tobacco Research Policy Programs. University of Kentucky, 2007. Available at: http://www.mc.uky.edu/tobaccopolicy/Ordinances/Smoke-freeOrdinances.HTM. Accessed March 22, 2008.
 
19. CDC. Estimated exposure of adolescents to state-funded anti-tobacco television advertisements—37 states and the District of Columbia, 1999–2003. MMWR Morb Mortal Wkly Rep 2005;54:1077–1080.
 
20. State System. Center for Disease Control. Available at: apps.nccd.cdc.gov/statesystem/stateSystem.aspx. Accessed May 4, 2007.
 
21. CDC. State medicaid coverage for tobacco-dependence treatments—United States, 1994–2002. MMWR Morb Mortal Wkly Rep 2004;53:54–57.
 
22. Hahn EJ, Rayens MK, Rasnake RT. Are kentucky schools using research-based curricula? Foresight 2001;8:6–9.
 
23. Tobacco. Substance Abuse and Mental Health Services Administration. Available at: http://prevention.samhsa.gov/tobacco/01synartable.asp. Accessed 2007.
 
24. Hahn EJ, Riker CA, Butler KM, et al. Enforcement of tobacco purchase, use and possession laws in four Kentucky communities. Policy Polit Nurs Pract 2007;8:140–147.
 
25. Kentucky: History, Geography, Population, and State Facts. Infoplease, 2005. Available at: http://www.infoplease.com/ipa/A0108217.html. Accessed March 22, 2008.