ArticleBMJ open2020
Novel microsimulation model of tobacco use behaviours and outcomes: calibration and validation in a US population.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- A Scoping Review of the Literature on Child and/or Adolescent Health Microsimulation Models.Applied health economics and health policy · 2026Review
- Protocol for the Mobile behavioral support plus varenicline for tobacco cessation among people living with HIV in India (MoVIe): A hybrid implementation-effectiveness randomized trial.Contemporary clinical trials · 2026Article
- Projected Impact of Higher E-cigarette or Combustible Cigarette Taxes on Use of Both Products in the U.S.AJPM focus · 2025Article
- Disparities in cigarette smoking and the health of marginalized populations in the U.S.: a simulation analysis.BMC public health · 2025Article
- Article
- Disparities in Tobacco Smoking and Risk of Cardiovascular Disease in People With Low Socioeconomic Status or Serious Psychological Distress: A Simulation Analysis.American journal of preventive medicine · 2025Article
- Initiation, cessation and relapse of tobacco smoking over a 3-year period among participants aged ≥15 years in a large longitudinal cohort in rural South Africa.PLOS global public health · 2025Article
- Development and Validation of a Simulation Model for Treatment to Maintain Remission in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.Arthritis care & research · 2023Observational
- Calibration and Validation of the Colorectal Cancer and Adenoma Incidence and Mortality (CRC-AIM) Microsimulation Model Using Deep Neural Networks.Medical decision making : an international journal of the Society for Medical Decision Making · 2023Article
- Article
- Validation of the Decision model of the Burden of Hearing loss Across the Lifespan (DeciBHAL) in Chile, India, and Nigeria.EClinicalMedicine · 2022Article
- Development and validation of the age-associated dementia policy (AgeD-Pol) computer simulation model in the USA and Europe.BMJ open · 2022Article
- Development and validation of DeciBHAL-US: A novel microsimulation model of hearing loss across the lifespan in the United States.EClinicalMedicine · 2022Article
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Authors and funding
14 authors.
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Abstract
BACKGROUND AND
objectiveSimulation models can project effects of tobacco use and cessation and inform tobacco control policies. Most existing tobacco models do not explicitly include relapse, a key component of the natural history of tobacco use. Our objective was to develop, calibrate and validate a novel individual-level microsimulation model that would explicitly include smoking relapse and project cigarette smoking behaviours and associated mortality risks.
methodsWe developed the Simulation of Tobacco and Nicotine Outcomes and Policy (STOP) model, in which individuals transition monthly between tobacco use states (current/former/never) depending on rates of initiation, cessation and relapse. Simulated individuals face tobacco use-stratified mortality risks. For US women and men, we conducted cross-validation with a Cancer Intervention and Surveillance Modeling Network (CISNET) model. We then incorporated smoking relapse and calibrated cessation rates to reflect the difference between a transient quit attempt and sustained abstinence. We performed external validation with the National Health Interview Survey (NHIS) and the linked National Death Index. Comparisons were based on root-mean-square error (RMSE).
resultsIn cross-validation, STOP-generated projections of current/former/never smoking prevalence fit CISNET-projected data well (coefficient of variation (CV)-RMSE≤15%). After incorporating smoking relapse, multiplying the CISNET-reported cessation rates for women/men by 7.75/7.25, to reflect the ratio of quit attempts to sustained abstinence, resulted in the best approximation to CISNET-reported smoking prevalence (CV-RMSE 2%/3%). In external validation using these new multipliers, STOP-generated cumulative mortality curves for 20-year-old current smokers and never smokers each had CV-RMSE ≤1% compared with NHIS. In simulating those surveyed by NHIS in 1997, the STOP-projected prevalence of current/former/never smokers annually (1998-2009) was similar to that reported by NHIS (CV-RMSE 12%).
conclusionsThe STOP model, with relapse included, performed well when validated to US smoking prevalence and mortality. STOP provides a flexible framework for policy-relevant analysis of tobacco and nicotine product use.
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