A Computational Model for Assessing the Population Health Impact of Introducing a Modified Risk Claim on an Existing Smokeless Tobacco Product

Raheema S. Muhammad-Kah, Yezdi B. Pithawalla, Edward L. Boone, Lai Wei, Michael A. Jones, Ryan A. Black, Thomas M. Bryan and Mohamadi A. Sarkar
Additional contact information
Raheema S. Muhammad-Kah: Regulatory Affairs, Center for Research & Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219, USA
Yezdi B. Pithawalla: Regulatory Affairs, Center for Research & Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219, USA
Edward L. Boone: Department of Statistical Sciences & Operations Research, Virginia Commonwealth University, Richmond, VA 23284, USA
Lai Wei: Regulatory Affairs, Center for Research & Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219, USA
Michael A. Jones: Regulatory Affairs, Center for Research & Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219, USA
Ryan A. Black: Regulatory Affairs, Center for Research & Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219, USA
Thomas M. Bryan: Regulatory Affairs, Center for Research & Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219, USA
Mohamadi A. Sarkar: Regulatory Affairs, Center for Research & Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219, USA

IJERPH, 2019, vol. 16, issue 7, 1-17

Abstract: Computational models are valuable tools for predicting the population effects prior to Food and Drug Administration (FDA) authorization of a modified risk claim on a tobacco product. We have developed and validated a population model using best modeling practices. Our model consists of a Markov compartmental model based on cohorts starting at a defined age and followed up to a specific age accounting for 29 tobacco-use states based on a cohort members transition pathway. The Markov model is coupled with statistical mortality models and excess relative risk ratio estimates to determine survival probabilities from use of smokeless tobacco. Our model estimates the difference in premature deaths prevented by comparing Base Case (“world-as-is”) and Modified Case (the most likely outcome given that a modified risk claim is authorized) scenarios. Nationally representative transition probabilities were used for the Base Case. Probabilities of key transitions for the Modified Case were estimated based on a behavioral intentions study in users and nonusers. Our model predicts an estimated 93,000 premature deaths would be avoided over a 60-year period upon authorization of a modified risk claim. Our sensitivity analyses using various reasonable ranges of input parameters do not indicate any scenario under which the net benefit could be offset entirely.

Keywords: population modeling; tobacco harm reduction; modified risk tobacco products; smokeless tobacco; modified risk tobacco product application; population level impact (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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