Cent Eur J Public Health 2008, 16(4):189-198 | DOI: 10.21101/cejph.a3486

The Role of Tobacco Control Policies in Reducing Smoking and Deaths Caused by Smoking in an Eastern European Nation: Results from the Albania SimSmoke Simulation Model

David T. Levy1, Hana Ross2, Eduard Zaloshnja1, Roland Shuperka3, Meriglena Rusta3
1 Pacific Institute for Research and Evaluation, Calverton, Maryland, USA
2 International Tobacco Control Research, American Cancer Society, Atlanta, USA
3 For a Tobacco-Free Albania, Tirana, Albania

The Albania SimSmoke simulation model is used to examine the effects of tobacco control policies. The model is used to consider the projected trends in smoking prevalence and associated smoking-attributable deaths in the absence of new policies, and then to examine the effect of new policies that are consistent with the Framework Convention for Tobacco Control (FCTC) on these outcomes.
The model shows that significant inroads to reducing smoking prevalence and premature mortality can be achieved through tax increases. A comprehensive strategy to further reduce smoking rates should include a media campaign complete with programs to publicize and enforce clean air laws, a comprehensive cessation treatment program, strong health warnings, advertising bans, and youth access laws.
Besides presenting the benefits of a comprehensive tobacco control strategy, the model helps to identify important information needed for both modeling and policymaking. The effectiveness of future tobacco control policy will require proper surveillance and evaluation schemes for Albania.

Keywords: tobacco control policy, FCTC, simulation model, Albania

Received: February 26, 2008; Revised: June 25, 2008; Accepted: June 25, 2008; Published: December 1, 2008  Show citation

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Levy DT, Ross H, Zaloshnja E, Shuperka R, Rusta M. The Role of Tobacco Control Policies in Reducing Smoking and Deaths Caused by Smoking in an Eastern European Nation: Results from the Albania SimSmoke Simulation Model. Cent Eur J Public Health. 2008;16(4):189-198. doi: 10.21101/cejph.a3486. PubMed PMID: 19256288.
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    References

    1. U.S. Department of Health and Human Services. Reducing the health consequences of smoking: 25 years of progress. A report of the Surgeon General. DHHS publication no. (CDC) 89-8411. Rockville: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1989.
    2. U.S. Department of Health and Human Services. The health benefits of smoking cessation: a report of the Surgeon General. DHHS publication no. (CDC) 90-8416. Rockville: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1990.
    3. Peto R, Lopez AD. Future worldwide health effects of current smoking patterns. In: Koop CE, Pearson CE, Schwarz M, editors. Critical issues in global health. San Francisco: Jossey-Bass; 2000. p. 154-161.
    4. Bobak M, Marmot M. East-West mortality divide and its potential explanations: proposed research agenda. BMJ. 1996 Feb 17;312(7028):421-5. Go to original source... Go to PubMed...
    5. Hopkins DP, Briss PA, Ricard CJ, Husten CG, Carande-Kulis VG, Fielding JE,etal;TaskForceonCommunityPreventiveServices.Reviewsofevidence regardinginterventionstoreducetobaccouseandexposuretoenvironmental tobacco smoke. Am J Prev Med. 2001 Feb;20(2 Suppl):16-66. Go to original source... Go to PubMed...
    6. Levy DT, Chaloupka F, Gitchell J. The effects of tobacco control policies on smoking rates: a tobacco control scorecard. J Public Health Manag Pract. 2004 Jul-Aug;10(4):338-53. Go to original source... Go to PubMed...
    7. U.S. Department of Health and Human Services. Preventing tobacco use among young people: a report of the Surgeon General. Atlanta: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1994.
    8. U.S. Department of Health and Human Services. Healthy people 2010. Atlanta: Centers for Disease Control and Prevention, Office of Disease Prevention and Health Promotion; 2000.
    9. Taylor DH Jr., Hasselblad V, Henley SJ, Thun MJ, Sloan FA. Benefits of smoking cessation for longevity.Am J Public Health. 2002 Jun;92(6):9906. Erratum in: Am J Public Health 2002 Sep;92(9):1389. Go to original source...
    10. Shuperka R. Living standard measurement survey. Tiranna: The World Bank; 2002.
    11. Hu TW, Sung HY, Keeler TE. Reducing cigarette consumption in California: tobacco taxes vs an anti-smoking media campaign. Am J Public Health. 1995 Sep;85(9):1218-22. Go to original source... Go to PubMed...
    12. Hu TW, Sung HY, Keeler TE The state antismoking campaign and the industry response: the effects of advertising on cigarette consumption in California. Am Econ Rev. 1995 May;85(2):85-90. Go to original source...
    13. Farrelly MC, Pechacek TF, Chaloupka FJ. The impact of tobacco control program expenditures on aggregate cigarette sales: 1981-2000. J Health Econ. 2003 Sep;22(2):843-59. Erratum in: J Health Econ. 2004 Mar;23(2):419. Go to original source... Go to PubMed...
    14. Homer JB, Hirsch GB. System dynamics modeling for public health: background and opportunities. Am J Public Health. 2006 Mar;96(3):452-8. Go to original source... Go to PubMed...
    15. Levy DT, Bauer JE, Lee HR. Simulation modeling and tobacco control: creating more robust public health policies. Am J Public Health. 2006 Mar;96(3):494-8. Go to original source... Go to PubMed...
    16. Mendez D, Warner KE, Courant PN. Has smoking cessation ceased? Expected trends in the prevalence of smoking in the United States. Am J Epidemiol. 1998 Aug 1;148(3):249-58. Go to original source... Go to PubMed...
    17. Mendez D, Warner KE.Adult cigarette smoking prevalence: declining as expected (not as desired). Am J Public Health. 2004 Feb;94(2):251-2. Go to original source... Go to PubMed...
    18. Tengs TO, Osgood ND, Lin TH. Public health impact of changes in smoking behavior: results from the Tobacco Policy Model. Med Care. 2001 Oct;39(10):1131-41. Go to original source... Go to PubMed...
    19. Tengs TO, Ahmad S, Moore R, Gage E. Federal policy mandating safer cigarettes: a hypothetical simulation of the anticipated population health gains or losses. J Policy Anal Manage. 2004 Aug,23(4):857-72. Go to original source... Go to PubMed...
    20. Ahmad S. Increasing excise taxes on cigarettes in California: a dynamic simulation of health and economic impacts. Prev Med. 2005 Jul;41(1):276-83. Go to original source... Go to PubMed...
    21. Ahmad S, Billimek J. Estimating the health impacts of tobacco harm reduction policies: a simulation modeling approach. Risk Anal. 2005 Aug;25(4):801-12. Go to original source... Go to PubMed...
    22. Ahmad S, Billimek J. Limiting youth access to tobacco: comparing the long-term health impacts of increasing cigarette excise taxes and raising the legal smoking age to 21 in the United States. Health Policy. 2007 Mar;80(3):378-91. Go to original source... Go to PubMed...
    23. Levy DT, Cummings KM, HylandA.Asimulation of the effects of youth initiation policies on overall cigarette use. Am J Public Health. 2000 Aug;90(8):1311-4. Go to original source... Go to PubMed...
    24. Levy DT, Nikolayev L, Mumford E. Recent trends in smoking and the role of public policies: results from the SimSmoke tobacco control policy simulation model. Addiction. 2005 Oct;100(10):1526-36. Go to original source... Go to PubMed...
    25. Levy DT, Nikolayev L, Mumford E, Compton C. The Healthy People 2010 smoking prevalence and tobacco control objectives: results from the SimSmoke tobacco control policy simulation model (United States). Cancer Causes Control. 2005 May;16(4):359-71. Go to original source... Go to PubMed...
    26. Levy DT, Chaloupka F, Gitchell J, Mendez D, Warner KE. The use of simulation models for the surveillance, justification and understanding of tobacco control policies. Health Care Manag Sci. 2002 Apr;5(2):113-20. Go to original source... Go to PubMed...
    27. McWhorter WP, Boyd GM, Mattson ME. Predictors of quitting smoking: the NHANES I followup experience. J Clin Epidemiol. 1990;43(12):1399-405. Go to original source... Go to PubMed...
    28. Gilpin EA, Pierce JP, Farkas AJ. Duration of smoking abstinence and success in quitting. J Natl Cancer Inst. 1997 Apr 16;89(8):572-6. Go to original source... Go to PubMed...
    29. Shultz JM, Novotny TE, Rice DP. Quantifying the disease impact of cigarette smoking with SAMMEC II software. Public Health Rep. 1991 May-Jun;106(3):326-33.
    30. Centers for Disease Control and Prevention. Cigarette smoking among adults - United States, 1998. MMWR Morb Mortal Wkly Rep. 2000 Oct 6;49(39):881-4.
    31. Wen CP,Tsai SP, Chen CJ, ChengTY.The mortality risks of smokers inTaiwan; Part I: cause-specific mortality. Prev Med. 2004 Sep;39(3):528-35. Go to original source...
    32. Jee SH, Lee JK, Kim IS. Smoking-attributable mortality among Korean adults: 1981-2003. Korean J Epidemiol. 2006 Jun;28(1):92-9.
    33. Peto R. Influence of dose and duration of smoking on lung cancer rates. IARC Sci Publ. 1986;(74):23-33.
    34. Thun MJ, Myers DG, Day-Lally C, Namboodiri NM, Calle EE, Flanders WD, et al.Age and the exposure-response relationships between cigarette smoking and premature death in Cancer Prevention Study II. In: Shopland DR, Burns DM, Garfinkel L, et al, editors. Changes in cigarette related disease risks and their implication for prevention and control Rockville: National Cancer Institute; 1997. p. 383-475.
    35. Burns D, Garfinkel L, Samet J, edsitors. Changes in cigarette-related disease risks and their implication for prevention and control. Bethesda: National Institutes of Health; 1997.
    36. Friend K, Levy DT. Reductions in smoking prevalence and cigarette consumption associated with mass-media campaigns. Health Educ Res. 2002 Feb;17(1):85-98. Go to original source...
    37. FriendK,LevyDT.Smokingtreatmentinterventionsandpoliciestopromote their use: a critical review. Nicotine Tob Res. 2001Nov;3(4):299-310. Go to original source...
    38. Levy DT, Friend K. Gauging the effects of mass media policies: what do we need to know? J Public Health Manag Pract. 2000 May;6(3):95106. Go to original source...
    39. Levy DT, Friend K. A framework for evaluating and improving clean indoor air laws. J Public Health Manag Pract. 2001 Sep;7(5):87-96. Go to original source...
    40. Levy DT, Friend K.Asimulation model of tobacco youth access policies. J Health Polit Policy Law. 2000 Dec;25(6):1023-50. Go to original source...
    41. Levy DT, Friend K. The effects of clean indoor air laws: what do we know and what do we need to know? Health Educ Res. 2003 Oct;18(5):592609. Go to original source...
    42. Hughes JR. Reduced smoking: an introduction and review of the evidence. Addiction. 2000 Jan;95 Suppl 1:S3-7. Go to original source... Go to PubMed...
    43. Hymowitz N, Cummings KM, Hyland A, Lynn WR, Pechacek TF, Hartwell TD. Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tob Control. 1997;6 Suppl 2:S57-62. Go to original source...
    44. Hymowitz N, Sexton M, Ockene J, Grandits G; MRFIT Research Group. Baseline factors associated with smoking cessation and relapse. Prev Med. 1991 Sep;20(5):590-601. Go to original source...
    45. Levy DT, Cummings KM, Hyland A. Increasing taxes as a strategy to reduce cigarette use and deaths: results of a simulation model. Prev Med. 2000 Sep;31(3):279-86. Go to original source... Go to PubMed...
    46. Chaloupka FJ, Hu TW, Warner KE, Jacobs R, Yurekli A. The taxation of tobacco products. In: Chaloupka FJ, Jha P, editors. Tobacco control in developing countries. New York: Oxford University Press; 2000. p. 237-72.
    47. Guindon EG, PerucicA-M, Boisclair D. Higher tobacco prices and taxes in South-East Asia: an effective tool to reduce tobacco use, save lives and generate revenue. Washington,D.C.: The World Bank; 2003.
    48. Sung HY, Hu TW, Keeler TE Cigarette taxation and demand: an empirical model. Contemp Econ Policy. 1994;12(3):91-100. Go to original source...
    49. Levy DT, Friend K, Polishchuk E. Effect of clean indoor air laws on smokers: the clean air module of the SimSmoke computer simulation model. Tob Control. 2001 Dec;10(4):345-51. Go to original source... Go to PubMed...
    50. Levy DT, Friend K. A computer simulation model of mass media interventions directed at tobacco use. Prev Med. 2001Mar;32(3):284-94. Go to original source... Go to PubMed...
    51. LevyDT,FriendK.Asimulationmodelofpoliciesdirectedattreatingtobacco use and dependence. Med Decis Making. 2002 Jan-Feb;22(1):6-17. Go to original source... Go to PubMed...
    52. Levy DT, Friend K. Examining the effects of tobacco treatment policies on smoking rates and smoking related deaths using the SimSmoke computer simulation model. Tob Control. 2002 Mar;11(1):47-54. Go to original source... Go to PubMed...
    53. Fiore M, BaileyW, Cohen S, Dorfman S, Goldstein M, Gritz E, et al.Treating tobacco use and dependence. Clinical practice guideline. Rockville: U.S. Department of Health and Human Services, Public Health Service; 2000.
    54. Zhu SH, Anderson CM, Johnson CE, Tedeschi G, Roeseler A. A centralized telephone service for tobacco cessation: the California experience. Tob Control. 2000;9 Suppl 2:II48-55. Go to original source...
    55. Cummings KM, Fix B, Celestino P, Carlin-Menter S, O'Connor R, Hyland A. Reach, efficacy, and cost-effectiveness of free nicotine medication giveaway programs. J Public Health Manag Pract. 2006 Jan-Feb;12(1):37-43. Go to original source... Go to PubMed...
    56. Jha P, Chaloupka F, editors. Tobacco control in developing countries. New York: Oxford University Press; 2000.
    57. Merriman D, Yurekli A, Chaloupka F. How big is the worldwide cigarette smuggling problem. In: Jha P, Chaloupka F, editors. Tobacco control in developing countries. New York: Oxford University Press; 2000. p. 365-92.

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