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The effect of tobacco control policies on smoking prevalence and smoking-attributable deaths in Ireland using the IrelandSS simulation model
  1. Laura M Currie1,2,
  2. Kenneth Blackman3,
  3. Luke Clancy2,
  4. David T Levy3,4
  1. 1Division of Population Health Science, Royal College of Surgeons in Ireland, Dublin, Ireland
  2. 2TobaccoFree Research Institute Ireland, Dublin, Ireland
  3. 3Pacific Institute for Research and Evaluation, Calverton, Maryland, USA
  4. 4Department of Oncology, Georgetown University, Washington, DC, USA
  1. Correspondence to Laura Currie, Royal College of Surgeons in Ireland, Division of Population Health Science, Beaux Lane House, Lower Mercer Street, Dublin 2, Ireland; lauracurrie{at}rcsi.ie

Abstract

Objectives This study estimates the relative contribution of policies implemented between 1998 and 2010 to reductions in smoking prevalence by 2010. It then models the impact of implementing stronger policies, relative to a scenario of inaction, on smoking prevalence and smoking-attributable mortality in Ireland.

Methods IrelandSS is an adapted version of SimSmoke, a dynamic simulation model used to examine the effect of tobacco control policies on smoking prevalence, through initiation and cessation, and associated future premature mortality.

Results Model predictions for smoking prevalence are reasonably close to those from surveys. As a result of tobacco control policies implemented between 1998 and 2010, there was a 22% relative reduction in smoking prevalence and 1716 fewer smoking-attributable deaths (SADs) by 2010 increasing to a 29% relative reduction in prevalence and 50 215 fewer SADs by 2040. With the introduction of stricter FCTC-compliant policies in 2011, the smoking prevalence can be decreased by as much as 13% initially, increasing to 28% by 30 years. With these stronger policies, a total of 24 768 SADs will be averted by 2040.

Conclusions Predictions from the IrelandSS model suggest that policies implemented between 1998 and 2010 have had considerable effect; however, appreciable reductions in smoking prevalence and SADs can still be achieved through increasing taxes, maintaining a high-intensity tobacco control media campaign, introducing graphic health warnings and improving smoking cessation services.

  • Tobacco control policy
  • smoking prevalence
  • smoking-attributable deaths
  • simulation model
  • Ireland
  • surveillance and monitoring
  • public policy
  • priority/special populations
  • global health
  • price
  • smoking caused disease
  • respiratory health
  • exposure assessment
  • prevalence
  • taxation and price
  • harm reduction
  • cessation
  • economics

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Footnotes

  • Funding This is a partial deliverable within the PPACTE Project ‘Pricing Policies and Control of Tobacco in Europe’ and is partly funded by the European Commission through FP7 HEALTH-F2-2009-223323. LC is an HRB PhD Scholar in Health Services Research partly funded by the HRB in Ireland under Grant no. PhD/2007/16.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement We generally adopt the following four-part plan for the dissemination of models and modelling results. (1) Enhancing understanding of model structures by keeping up to date versions of documentation on the PPACTE website. (2) Active solicitation of enquiries from outside modellers and interested end users of results based on national or regional issues of interest amenable to modelling. (3) Enhancing the ability of others to run the models directly by developing publicly accessible versions of executable programmes of model or model subcomponents when feasible. (4) Enhancing access to source code by releasing code in the context of collaborations or other specified scenarios. Outside groups may be interested in obtaining source code from one or more of the models for research or commercial purposes. When feasible, collaborations will be pursued. Dr Levy has a long history of releasing executable versions of its SimSMOKE model for use by national and state Departments of Public Health or other entities and will continue to pursue such collaborations. In many cases, however, significant effort may be required to provide ongoing support, so that users could generate valid output and could interpret it correctly. In this case, we will need to obtain future funding for work.