scholarly journals How much of the future mortality toll of smoking can be avoided?

2020 ◽  
pp. tobaccocontrol-2019-055530 ◽  
Author(s):  
Kenneth E Warner ◽  
David Mendez
Keyword(s):  
Premature Mortality ◽  
Smoking Initiation ◽  
Vital Statistics ◽  
Status Quo ◽  
Initiation Rate ◽  
Mortality Burden ◽  
Life Years ◽  
The Us ◽  
The Future ◽  
The Usa

ObjectiveTo determine how much future smoking-related mortality in the USA can be prevented, recognising that some of that future mortality results from past smoking.MethodsEmploying a dynamic population simulation model, we estimate smoking’s expected mortality burden in the USA, measured as life-years lost (LYL), in a status-quo scenario run from 2018 through 2100. We then estimate LYL attributable to past smoking assuming that all smoking ceases at the end of 2017. We calculate the potential avoidable LYL, which we call the maximum potential reduction in premature mortality (MPRPM), as the difference between the two. We use data from the US Census Bureau, National Vital Statistics Reports, the National Health Interview Survey and Cancer Prevention Study II.ResultsUnder status-quo assumptions, smoking will claim 305 million LYL in the US from 2018 to 2100. If all smoking ceased at the end of 2017, past smoking would be responsible for 191.8 million LYL. Thus, avoidable LYL by 2100—the MPRPM—would be 113.2 million, 37% of the expected toll of smoking. A sensitivity analysis finds that were the annual smoking initiation rate 3% instead of 7.8%, the MPRPM would be 13-14% lower. Were the annual permanent smoking cessation rate twice our status-quo estimate of 4.35%, the MPRPM would be 38-39% lower.ConclusionsPublic health can address only the future toll of future smoking. Smoking’s MPRPM is the reduction in the mortality burden of smoking that tobacco control can strive to achieve.

Public health impact of a US ban on menthol in cigarettes and cigars: a simulation study

2021 ◽  
pp. tobaccocontrol-2021-056604
Author(s):  
David T Levy ◽  
Rafael Meza ◽  
Zhe Yuan ◽  
Yameng Li ◽  
Christopher Cadham ◽  
...  
Keyword(s):  
Public Health ◽  
Smoking Initiation ◽  
Health Impact ◽  
Status Quo ◽  
Expert Elicitation ◽  
Sensitivity Analyses ◽  
Public Health Impact ◽  
Menthol Cigarette ◽  
Life Years ◽  
Life Years Lost

IntroductionThe US Food and Drug Administration most recently announced its intention to ban menthol cigarettes and cigars nationwide in April 2021. Implementation of the ban will require evidence that it would improve public health. This paper simulates the potential public health impact of a ban on menthol in cigarettes and cigars through its impacts on smoking initiation, smoking cessation and switching to nicotine vaping products (NVPs).MethodsAfter calibrating an established US simulation model to reflect recent use trends in cigarette and NVP use, we extended the model to incorporate menthol and non-menthol cigarette use under a status quo scenario. Applying estimates from a recent expert elicitation on the behavioural impacts of a menthol ban, we developed a menthol ban scenario with the ban starting in 2021. We estimated the public health impact as the difference between smoking and vaping-attributable deaths and life-years lost in the status quo scenario and the menthol ban scenario from 2021 to 2060.ResultsAs a result of the ban, overall smoking was estimated to decline by 15% as early as 2026 due to menthol smokers quitting both NVP and combustible use or switching to NVPs. These transitions are projected to reduce cumulative smoking and vaping-attributable deaths from 2021 to 2060 by 5% (650 000 in total) and reduce life-years lost by 8.8% (11.3 million). Sensitivity analyses showed appreciable public health benefits across different parameter specifications.Conclusions and relevanceOur findings strongly support the implementation of a ban on menthol in cigarettes and cigars.

Japan and the Revolution in Military Affairs

2018 ◽  
Vol 5 (2) ◽  
pp. 172-196
Author(s):  
Tom Le
Keyword(s):  
Armed Forces ◽  
The Self ◽  
The Us ◽  
The Future ◽  
Revolution In Military Affairs ◽  
The Usa ◽  
Self Defence ◽  
The Revolution

The Revolution in Military Affairs (RMA) has not only changed how the USA engages in warfare but also how it maintains its military supremacy and how other nations budget and strategize. The very idea of the RMA has impacted how nations manage their technological advantages and raises the questions of can the RMA be monopolized and if not, which nations can adopt their own RMA? In September 2000, the Japan Defence Agency (now the Ministry of Defence [MOD]) produced a report titled ‘“Info-RMA”: Study on Info-RMA and the Future of the Self-Defence Forces’ to explore the prospects of implementing RMA principles in the Japan Self-Defence Forces. In this article, I explore to what extent can RMA principles be implemented in the Self-Defence Forces? I argue that although several significant changes have been implemented in technology, doctrine, operations and organization, various normative and technical constraints have directed the MOD to craft an RMA with Japanese characteristics, emphasizing defence and interconnectedness with the US armed forces. These findings suggest that current efforts to ‘normalize’ the Self-Defence Forces can succeed if crafted to appeal to the sensibilities of the Japanese public.

scholarly journals Impact of COVID-19 Attributable Deaths on Longevity, Premature Mortality and DALY: Estimates of USA, Italy, Sweden and Germany

2020 ◽  
Author(s):  
Sanjay K Mohanty ◽  
Manisha Dubey ◽  
Udaya S Mishra ◽  
Umakanta Sahoo
Keyword(s):  
Life Expectancy ◽  
Premature Mortality ◽  
Actual Number ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Control And Prevention ◽  
The Usa ◽  
The Impact ◽  
United Nation

AbstractIn a short span of four months, the COVID-19 pandemic has added over 0.4 million deaths worldwide, which are untimely, premature and unwarranted. The USA, Italy, Germany and Sweden are four worst affected countries, accounting to over 40% of COVID-19 deaths globally. The main objective of this study is to examine the impact of COVID-19 attributable deaths on longevity, years of potential life lost (YPLL) and disability adjusted life years (DALY) in USA, Italy, Germany and Sweden. Data from United Nation Population Projection, Statista and centre for disease control and prevention were used in the analyses. Life expectancy, YPLL and DALY were estimated under four scenarios; no COVID-19 deaths, actual number of COVID-19 death as of 22nd May, 2020 and anticipating COVID-19 death share of 6% and 10% respectively. The COVID-19 attributable deaths have lowered the life expectancy by 0.4 years each in USA and Sweden, 0.5 years in Italy and 0.1 years in Germany. The loss of YPLL was 1.5, 0.5, 0.1 and 0.5 million in USA, Italy, Germany and Sweden respectively. The DALY (per 1000 population) due to COVID-19 was 4 in USA, 6 in Italy, 1 each in Germany and Sweden. Compression in life expectancy and increase in YPLL and DALY may intensify further if death continues to soar. COVID-19 has a marked impact on mortality. Reduction in longevity premature mortality and loss of DALY is higher among elderly.

scholarly journals Public Health Implications of Vaping in the US: The Smoking and Vaping Simulation Model

2020 ◽  
Author(s):  
David T Levy ◽  
Jamie Tam ◽  
Luz Maria María Sanchez-Romero ◽  
Yameng Li ◽  
Zhe Yuan ◽  
...  
Keyword(s):  
Public Health ◽  
Smoking Cessation ◽  
Smoking Initiation ◽  
Health Impact ◽  
Health Implications ◽  
Relative Risks ◽  
Life Years ◽  
Wide Range ◽  
The Us ◽  
High Degree

Abstract Background Nicotine vaping products (NVPs) are increasingly popular worldwide. They may provide public health benefits if used as a substitute for smoking, but may create public health harms if used as a gateway to smoking or to discourage smoking cessation. This paper presents the Smoking and Vaping Model (SAVM), which estimates the public health implications of NVPs in the US. Methods SAVM adopts a cohort-approach and is available on an Excel platform. We derive public health implications by comparing smoking- and NVP-attributable deaths under a No-NVP and an NVP Scenario. The No-NVP Scenario projects current, former and never smoking rates via smoking initiation and cessation rates, and incorporates excess risks of smoking. The NVP Scenario allows for NVP relative excess risks, switching from cigarette to NVP use, separate NVP and smoking initiation rates, and separate NVP and smoking cessation rates. The model is validated against recent US survey data on smoking and vaping prevalence. Results The SAVM projects that under current patterns of US NVP use and substitution, NVP use will translate into 5.8 million premature smoking- and vaping-attributable deaths avoided and 96.4 million life years gained between 2013 and 2100. Sensitivity analysis shows that parameters for NVP relative risks, NVP-related switching and smoking cessation are particularly influential in gauging public health impacts. Discussion The SAVM shows potential benefits of e-cigarette use over a wide range of parameters. However, there is a high degree of uncertainty regarding key parameters. Policymakers, researchers and other public health stakeholders can apply the SAVM to estimate the potential public health impact of NVPs in their country or region using their own data sources.

An estimation of the harm of menthol cigarettes in the United States from 1980 to 2018

2021 ◽  
pp. tobaccocontrol-2020-056256
Author(s):  
Thuy TT Le ◽  
David Mendez
Keyword(s):  
Smoking Prevalence ◽  
Smoking Initiation ◽  
The United States ◽  
Slowing Down ◽  
Premature Deaths ◽  
Menthol Cigarettes ◽  
Life Years ◽  
The Us ◽  
Interview Survey ◽  
Life Years Lost

BackgroundMenthol cigarettes are thought to encourage smoking initiation among youths and young adults and make it more difficult for smokers to quit, thus increasing cigarette harm. However, no study to date has quantified the damage that menthol cigarettes have caused the US population.ObjectiveTo estimate the excess smoking prevalence, smoking initiation, and mortality in the US from 1980 through 2018 that can be attributed to menthol cigarettes.MethodsUsing a well-established simulation model of smoking prevalence and health effects and data from the National Health Interview Survey (NHIS), we first reproduced the overall US adult smoking prevalence between 1980 and 2018 (pseudo-R2=0.98) and associated mortality. Then we re-ran the model, assuming that menthol cigarettes were not present in the market over the same period. Finally, we compared both scenarios to quantify the public health harm attributable to menthol over the 1980–2018 period.ResultsFrom 1980 to 2018, we found that menthol cigarettes were responsible for slowing down the decline in smoking prevalence by 2.6 percentage points (13.7% vs 11.1% in 2018). Our results also show that menthol cigarettes were responsible for 10.1 million extra smokers, 3 million life years lost and 378 000 premature deaths during that period.ConclusionsWith millions of excess smoking initiators and thousands of smoking-related deaths due to mentholated cigarettes from 1980 through 2018, our results indicate that these products have had a significant detrimental impact on the public’s health and could continue to pose a substantial health risk. Our findings can assist the Food and Drug Administration in evaluating potential regulatory actions for mentholated tobacco products.

Racial inequity in fatal US police shootings, 2015–2020

2020 ◽  
pp. jech-2020-215097 ◽  
Author(s):  
Elle Lett ◽  
Emmanuella Ngozi Asabor ◽  
Theodore Corbin ◽  
Dowin Boatright
Keyword(s):  
Native American ◽  
Mixed Models ◽  
Years Of Life Lost ◽  
Washington Post ◽  
Death Rates ◽  
Mortality Burden ◽  
The Us ◽  
Police Shootings ◽  
The Usa ◽  
Racial Ethnic

IntroductionViolent encounters with police represent a significant cause of morbidity and mortality in the USA, especially among Black, Indigenous, and People of Colour (BIPOC). This study characterises trends in fatal police shootings overall and by armed status and quantifies inequities in mortality burden and years of life lost (YLL) across racial/ethnic groups.MethodsLongitudinal study of Washington Post data on fatal police shootings in the USA using generalised linear-mixed models to capture trends with time and relative rates.ResultsThis study shows that the rate of fatal police shootings for Black, Indigenous, and People of Colour (BIPOC) is constant from 2015 to 2020. Further, BIPOC have significantly higher death rates compared with Whites in the overall victim pool (Native American RR=3.06, Black RR=2.62, Hispanic RR=1.29) and among unarmed victims (Black RR=3.18, Hispanic RR=1.45). Native American (RR=3.95), Black (overall RR=3.29, unarmed RR=3.49) and Hispanic (RR=1.55, unarmed RR=1.55), victims had similarly high rates of YLL relative to Whites.ConclusionFatal police shootings are a public health emergency that contribute to poor health for BIPOC. Urgent attention from health professionals is needed to help drive policy efforts that reduce this unjust burden and move us towards achieving health equity in the US.

scholarly journals Public health implications of vaping in the USA: the smoking and vaping simulation model

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
David T. Levy ◽  
Jamie Tam ◽  
Luz María Sanchez-Romero ◽  
Yameng Li ◽  
Zhe Yuan ◽  
...  
Keyword(s):  
Public Health ◽  
Sensitivity Analysis ◽  
Smoking Cessation ◽  
Smoking Initiation ◽  
Mortality Rates ◽  
Base Case ◽  
Health Implications ◽  
The Public ◽  
Life Years ◽  
The Usa

Abstract Background Nicotine vaping products (NVPs) are increasingly popular worldwide. They may provide public health benefits if used as a substitute for smoking, but may create public health harms if used as a gateway to smoking or to discourage smoking cessation. This paper presents the Smoking and Vaping Model (SAVM), a user-friendly model which estimates the public health implications of NVPs in the USA. Methods SAVM adopts a cohort approach. We derive public health implications by comparing smoking- and NVP-attributable deaths and life-years lost under a No-NVP and an NVP Scenario. The No-NVP Scenario projects current, former, and never smoking rates via smoking initiation and cessation rates, with their respective mortality rates. The NVP Scenario allows for smoking- and NVP-specific mortality rates, switching from cigarette to NVP use, separate NVP and smoking initiation rates, and separate NVP and smoking cessation rates. After validating the model against recent US survey data, we present the base model with extensive sensitivity analyses. Results The SAVM projects that under current patterns of US NVP use and substitution, NVP use will translate into 1.8 million premature smoking- and vaping-attributable deaths avoided and 38.9 million life-years gained between 2013 and 2060. When the NVP relative risk is set to 5%, the results are sensitive to the level of switching and smoking cessation rates and to a lesser extent smoking initiation rates. When the NVP relative risk is raised to 40%, the public health gains in terms of averted deaths and LYL are reduced by 42% in the base case, and the results become much more sensitive to variations in the base case parameters. Discussion Policymakers, researchers, and other public health stakeholders can apply the SAVM to estimate the potential public health impact of NVPs in their country or region using their own data sources. In developing new simulation models involving NVPs, it will be important to conduct extensive sensitivity analysis and continually update and validate with new data. Conclusion The SAVM indicates the potential benefits of NVP use. However, given the uncertainty surrounding model parameters, extensive sensitivity analysis becomes particularly important.

scholarly journals Propaganda and Lobbying against the Future Prospect of Pakistan: Causes, effects and its Implications

2020 ◽  
Vol V (III) ◽  
pp. 155-163
Author(s):  
Shabnam Gul ◽  
Muhammad Faizan Asghar
Keyword(s):  
Foreign Policy ◽  
Saudi Arabia ◽  
Cold War ◽  
Future Prospect ◽  
The Other ◽  
Policy Tools ◽  
The Us ◽  
The Future ◽  
The Usa ◽  
The Cold War

The concept of propaganda and lobbying is not new to researchers. Historically, propaganda was used by many states to manipulate policies in their own favors and to oppose the other states. During WW1, WW2 and the Cold war, media was used as a propaganda tool to demoralize opponents. Gradually lobbying was initiated as foreign policy tools. Like Israel, Saudi Arabia and Russia was the most powerful lobbyist in the USA. Indian lobbyist started an anti-Pakistan campaign in the USA based on rivalry since the creation of Pakistan. This is true focuses on destabilization of the US-Pakistan relationship and to weaken the strong lobbyism between the US and Pakistan.

scholarly journals Projecting the effects of tobacco control policies in the USA through microsimulation: a study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019169 ◽  
Author(s):  
Jamie Tam ◽  
David T Levy ◽  
Jihyoun Jeon ◽  
John Clarke ◽  
Scott Gilkeson ◽  
...  
Keyword(s):  
Tobacco Control ◽  
Computational Models ◽  
Smoking Prevalence ◽  
Smoking Initiation ◽  
Control Programme ◽  
Smoking History ◽  
Control Policies ◽  
Tobacco Control Policies ◽  
Life Years ◽  
The Usa

IntroductionSmoking remains the leading cause of preventable death in the USA but can be reduced through policy interventions. Computational models of smoking can provide estimates of the projected impact of tobacco control policies and can be used to inform public health decision making. We outline a protocol for simulating the effects of tobacco policies on population health outcomes.Methods and analysisWe extend the Smoking History Generator (SHG), a microsimulation model based on data from the National Health Interview Surveys, to evaluate the effects of tobacco control policies on projections of smoking prevalence and mortality in the USA. The SHG simulates individual life trajectories including smoking initiation, cessation and mortality. We illustrate the application of the SHG policy module for four types of tobacco control policies at the national and state levels: smoke-free air laws, cigarette taxes, increasing tobacco control programme expenditures and raising the minimum age of legal access to tobacco. Smoking initiation and cessation rates are modified by age, birth cohort, gender and years since policy implementation. Initiation and cessation rate modifiers are adjusted for differences across age groups and the level of existing policy coverage. Smoking prevalence, the number of population deaths avoided, and life-years gained are calculated for each policy scenario at the national and state levels. The model only considers direct individual benefits through reduced smoking and does not consider benefits through reduced exposure to secondhand smoke.Ethics and disseminationA web-based interface is being developed to integrate the results of the simulations into a format that allows the user to explore the projected effects of tobacco control policies in the USA. Usability testing is being conducted in which experts provide feedback on the interface. Development of this tool is under way, and a publicly accessible website is available athttp://www.tobaccopolicyeffects.org.

Measurement Invariance of a Universal Behavioral Screener Across Samples From the USA and Germany

2018 ◽  
Vol 34 (2) ◽  
pp. 87-100 ◽  
Author(s):  
Gino Casale ◽  
Robert J. Volpe ◽  
Brian Daniels ◽  
Thomas Hennemann ◽  
Amy M. Briesch ◽  
...  
Keyword(s):  
Measurement Invariance ◽  
Student Behavior ◽  
Cross Cultural ◽  
Cross Cultural Comparison ◽  
School Based ◽  
Cultural Research ◽  
Universal Screener ◽  
Confirmatory Factor ◽  
The Us ◽  
The Usa

Abstract. The current study examines the item and scalar equivalence of an abbreviated school-based universal screener that was cross-culturally translated and adapted from English into German. The instrument was designed to assess student behavior problems that impact classroom learning. Participants were 1,346 K-6 grade students from the US (n = 390, Mage = 9.23, 38.5% female) and Germany (n = 956, Mage = 8.04, 40.1% female). Measurement invariance was tested by multigroup confirmatory factor analysis (CFA) across students from the US and Germany. Results support full scalar invariance between students from the US and Germany (df = 266, χ2 = 790.141, Δχ2 = 6.9, p < .001, CFI = 0.976, ΔCFI = 0.000, RMSEA = 0.052, ΔRMSEA = −0.003) indicating that the factor structure, the factor loadings, and the item thresholds are comparable across samples. This finding implies that a full cross-cultural comparison including latent factor means and structural coefficients between the US and the German version of the abbreviated screener is possible. Therefore, the tool can be used in German schools as well as for cross-cultural research purposes between the US and Germany.

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