{"doi":"10.1136/bmjopen-2019-032579","title":"Novel microsimulation model of tobacco use behaviours and outcomes: calibration and validation in a US population","abstract":"BACKGROUND AND OBJECTIVE: Simulation 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. METHODS: We 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). RESULTS: In 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%). CONCLUSIONS: The 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.","journal":"BMJ Open","year":2020,"id":81115,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":14,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9324,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":419955,"name":"Alexander J.B. Bulteel","orcid":"0000-0001-5168-2708","position":1,"is_corresponding":false},{"id":419956,"name":"Douglas E. Levy","orcid":"0000-0001-9446-7899","position":2,"is_corresponding":false},{"id":421176,"name":"Pamela R Torola","orcid":null,"position":3,"is_corresponding":false},{"id":273590,"name":"Emily P. Hyle","orcid":"0000-0001-8721-106X","position":4,"is_corresponding":false},{"id":421177,"name":"Taige Hou","orcid":null,"position":5,"is_corresponding":false},{"id":421178,"name":"Benjamin Osher","orcid":null,"position":6,"is_corresponding":false},{"id":402426,"name":"Liyang Yu","orcid":"0000-0001-6050-2190","position":7,"is_corresponding":false},{"id":273586,"name":"Fatma M. Shebl","orcid":"0000-0002-9750-0049","position":8,"is_corresponding":false},{"id":226455,"name":"A. David Paltiel","orcid":"0000-0002-4861-3290","position":9,"is_corresponding":false},{"id":273595,"name":"Kenneth A. Freedberg","orcid":"0000-0001-6471-7930","position":10,"is_corresponding":false},{"id":276220,"name":"Milton C. Weinstein","orcid":null,"position":11,"is_corresponding":false},{"id":103417,"name":"Nancy A. Rigotti","orcid":"0000-0002-2223-1657","position":12,"is_corresponding":false},{"id":226457,"name":"Rochelle P. Walensky","orcid":"0000-0002-8795-379X","position":13,"is_corresponding":false},{"id":273585,"name":"Krishna P. Reddy","orcid":"0000-0002-1832-2193","position":0,"is_corresponding":true}],"reference_count":63,"raw_metadata":null,"created_at":"2026-07-18T21:52:34.401799Z","pmid":"32404384","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}