Tobacco smoking: effect of interventions¶

Each chronic and acute disease that is affected by tobacco smoking is modelled as a separate component, so that interventions on tobacco smoking can affect the morbidity and mortality of these diseases. We also need to inform the tobacco component which diseases it should affect; this is done in the configuration section. The resulting simulation definition is quite long, simply because there are many diseases to include.

The simulation definition for the BAU scenario.¶

plugins:
    optional:
        data:
            controller: "vivarium_public_health.dataset_manager.ArtifactManager"
            builder_interface: "vivarium_public_health.dataset_manager.ArtifactManagerInterface"

components:
    vivarium_public_health:
        mslt:
            population:
                - BasePopulation()
                - Mortality()
                - Disability()
            delay:
                - DelayedRisk('tobacco')
            disease:
                - Disease('CHD')
                - Disease('Stroke')
                - Disease('LungCancer')
                - Disease('HeadNeckCancer')
                - Disease('OesophagusCancer')
                - Disease('StomachCancer')
                - Disease('LiverCancer')
                - Disease('ColorectalCancer')
                - Disease('PancreasCancer')
                - Disease('CervicalCancer')
                - Disease('BladderCancer')
                - Disease('KidneyCancer')
                - Disease('EndometrialCancer')
                - Disease('Melanoma')
                - Disease('ThyroidCancer')
                - Disease('COPD')
                - AcuteDisease('LRTI')
            observer:
                - MorbidityMortality()
                - TobaccoPrevalence()

configuration:
    input_data:
        # Change this to "mslt_tobacco_maori_20-years.hdf" for the Maori
        # population.
        artifact_path: artifacts/mslt_tobacco_non-maori_20-years.hdf
        input_draw_number: 0
    population:
        population_size: 44 # Male and female 5-year cohorts, aged 0 to 109.
    time:
        start:
            year: 2011
        end:
            year: 2120
        step_size: 365  # In days
    tobacco:
        delay: 20  # The delay (in years) between cessation and normal risks.
        affects:
            # This is where the affected diseases should be listed.
            CHD:
            COPD:
            BladderCancer:
            CervicalCancer:
            ColorectalCancer:
            EndometrialCancer:
            KidneyCancer:
            LiverCancer:
            LungCancer:
            OesophagusCancer:
            PancreasCancer:
            StomachCancer:
            ThyroidCancer:
            LRTI:
            Melanoma:
            Stroke:
    observer:
        output_prefix: mslt_tobacco_bau # The prefix for output files.

Tobacco eradication¶

We add the TobaccoEradication component, and specify at what year it comes into effect. Shown below are the new lines that are added to the simulation definition for the BAU scenario.

components:
    vivarium_public_health:
        mslt:
            # Other components ...
            intervention:
                TobaccoEradication()

configuration:
    # Other configuration settings ...
    tobacco_eradication:
        year: 2011

These simulations are already defined in the following files:

mslt_tobacco_maori_20-years_decreasing_erad.yaml
mslt_tobacco_non-maori_20-years_decreasing_erad.yaml

Tobacco-free generation¶

We add the TobaccoFreeGeneration component, and specify at what year it comes into effect. Shown below are the new lines that are added to the simulation definition for the BAU scenario.

components:
    vivarium_public_health:
        mslt:
            # Other components ...
            intervention:
                TobaccoFreeGeneration()

configuration:
    # Other configuration settings ...
    tobacco_free_generation:
        year: 2011

These simulations are already defined in the following files:

mslt_tobacco_maori_20-years_decreasing_tfg.yaml
mslt_tobacco_non-maori_20-years_decreasing_tfg.yaml

Tobacco tax¶

We enable the tobacco_tax option of the tobacco risk factor (DelayedRisk). Shown below are the new lines that are added to the simulation definition for the BAU scenario.

configuration:
    # Other configuration settings ...
    tobacco:
        tobacco_tax: True

These simulations are already defined in the following files:

mslt_tobacco_maori_20-years_decreasing_tax.yaml
mslt_tobacco_non-maori_20-years_decreasing_tax.yaml

Intervention comparison¶

If you run all of these simulations, you can then compare them by the gains that they provide in LYs and HALYs, and the reductions that they provide in ACMR and YLDR, using the data analysis software of your choice.

As an example, here are some of the results obtained for non-Maori males aged 50-54 in 2011, for the tobacco eradication intervention:

Results for the tobacco eradication intervention, which yields gains in LYs, HALYs, ACMR, and YLDR.¶
Year of birth	Sex	Age	Year	Survivors	BAU Survivors	Population	BAU Population	ACMR	BAU ACMR	Probability of death	BAU Probability of death	Deaths	BAU Deaths	YLD rate	BAU YLD rate	Person years	BAU Person years	HALYs	BAU HALYs	LE	BAU LE	HALE	BAU HALE
…
1959	male	52	2011	129,460.4	129,460.4	129,850.0	129,850.0	0.003	0.003	0.003	0.003	389.6	389.6	0.1122	0.1122	129,655.2	129,655.2	115,103.4	115,103.4	33.4	33.1	26.3	26.0
1959	male	53	2012	129,047.3	129,047.0	129,460.4	129,460.4	0.0032	0.0032	0.0032	0.0032	413.2	413.5	0.1122	0.1122	129,253.9	129,253.7	114,749.9	114,746.9	32.5	32.2	25.5	25.2
1959	male	54	2013	128,608.7	128,607.5	129,047.3	129,047.0	0.0034	0.0034	0.0034	0.0034	438.5	439.5	0.1122	0.1122	128,828.0	128,827.2	114,374.8	114,368.3	31.6	31.3	24.7	24.4
…
1959	male	108	2067	149.5	136.4	241.4	220.7	0.4794	0.4811	0.3809	0.3819	92.0	84.3	0.3553	0.3578	195.5	178.6	126.0	114.7	1.6	1.6	1.0	1.0
1959	male	109	2068	92.5	84.3	149.5	136.4	0.4795	0.4811	0.3809	0.3819	56.9	52.1	0.3555	0.3578	121.0	110.4	78.0	70.9	1.3	1.3	0.8	0.8
1959	male	110	2069	57.3	52.1	92.5	84.3	0.4797	0.4812	0.3811	0.382	35.3	32.2	0.3556	0.3578	74.9	68.2	48.3	43.8	0.8	0.8	0.5	0.5
…