{"doi":"10.1371/journal.pone.0284426","title":"Longitudinal transitions in initiation, cessation, and relapse of cigarette smoking and e-cigarette use among US youth and adults: Validation of a microsimulation model","abstract":"INTRODUCTION: Estimates of initiation, cessation, and relapse rates of tobacco cigarette smoking and e-cigarette use can facilitate projections of longer-term impact of their use. We aimed to derive transition rates and apply them to validate a microsimulation model of tobacco that newly incorporated e-cigarettes. METHODS: We fit a Markov multi-state model (MMSM) for participants in Waves 1-4.5 of the Population Assessment of Tobacco and Health (PATH) longitudinal study. The MMSM had nine cigarette smoking and e-cigarette use states (current/former/never use of each), 27 transitions, two sex categories, and four age categories (youth: 12-17y; adults: 18-24y/25-44y/≥45y). We estimated transition hazard rates, including initiation, cessation, and relapse. We then validated the Simulation of Tobacco and Nicotine Outcomes and Policy (STOP) microsimulation model, by: (a) using transition hazard rates derived from PATH Waves 1-4.5 as inputs, and (b) comparing STOP-projected prevalence of smoking and e-cigarette use at 12 and 24 months to empirical data from PATH Waves 3 and 4. We compared the goodness-of-fit of validations with \"static relapse\" and \"time-variant relapse,\" wherein relapse rates did not or did depend on abstinence duration. RESULTS: Per the MMSM, youth smoking and e-cigarette use was generally more volatile (lower probability of maintaining the same e-cigarette use status over time) than that of adults. Root-mean-squared error (RMSE) for STOP-projected versus empirical prevalence of smoking and e-cigarette use was <0.7% for both static and time-variant relapse simulations, with similar goodness-of-fit (static relapse: RMSE 0.69%, CI 0.38-0.99%; time-variant relapse: RMSE 0.65%, CI 0.42-0.87%). PATH empirical estimates of prevalence of smoking and e-cigarette use were mostly within the margins of error estimated by both simulations. DISCUSSION: A microsimulation model incorporating smoking and e-cigarette use transition rates from a MMSM accurately projected downstream prevalence of product use. The microsimulation model structure and parameters provide a foundation for estimating the behavioral and clinical impact of tobacco and e-cigarette policies.","journal":"PLoS ONE","year":2023,"id":344225,"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":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8977,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":426763,"name":"Farzad Noubary","orcid":"0000-0003-4565-6268","position":1,"is_corresponding":false},{"id":103417,"name":"Nancy A. Rigotti","orcid":"0000-0002-2223-1657","position":2,"is_corresponding":false},{"id":273585,"name":"Krishna P. Reddy","orcid":"0000-0002-1832-2193","position":3,"is_corresponding":false},{"id":817357,"name":"Eli Schwamm","orcid":"0000-0001-6079-8796","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-19T01:11:30.951510Z","pmid":"37058462","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":[]}