Integrating Social Dynamics Into Modeling Cigarette and E-Cigarette Use. (April 2020)

• Record Type: Journal Article
• Authors: Chu, Kar-Hai; Shensa, Ariel; Colditz, Jason B.; Sidani, Jaime E.; Hoffman, Beth L.; Sinclair, David; Krauland, Mary G.; Primack, Brian A.
• Is Part Of: Health education & behavior. Volume 47:Number 2(2020:Apr.)
• Page Start: 191
• Page End: 201
• Publication Date: 2020-04
• Subjects: agent-based model -- cigarette -- e-cigarette -- nicotine -- population model -- social contagion; Health education -- Periodicals; Health behavior -- Periodicals; 613.05
• DOI: 10.1177/1090198119876242
• Languages: English
• ISSNs: 1090-1981

Abstract

Background . The use of electronic cigarettes (e-cigarette) offers potential to facilitate cigarette smoking cessation, yet potentially increases risk of cigarette smoking initiation. This relationship has been primarily modeled in mathematical ways that often do not represent real-world complexities, which could inform decisions regarding local prevention programs or policies. Aims . To develop a model of cigarette and e-cigarette use that combines current research on tobacco use and incorporates real-world geographic and demographic data. Method . We used a platform for developing agent-based models with demographic information representative of the population in Pennsylvania. We developed three models of cigarette and e-cigarette use. The primary outcome for each was the total number of users for cigarette, e-cigarette, and total nicotine. The first model applied current cigarette and e-cigarette data, the second tested the effect of implementing a program of e-cigarette education and policies, and the third considered a social contagion factor, where local schools functioned as a transmission vector. Results . The baseline and social contagion models found an overall decline in cigarette use but an increase in e-cigarette and total nicotine use. The education/policies model had declines in all categories. Sensitivity analysis suggested the importance of nuanced e-cigarette/cigarette interactions when modeling tobacco use. Discussion . Public health campaigns that focus on reducing youth e-cigarette usage can have a large effect. Social contagion should be strongly considered when studying e-cigarette spread. Conclusion . Targeted public health campaigns focused on reducing school prevalence of e-cigarette use may be particularly valuable.