The World Health Organization (1999) predicts that worldwide mortality from tobacco is likely to rise from about four million deaths a year in 1998 to about 10 million deaths a year by 2030. Most of this increase stems from tobacco use in low income countries: Murray and Lopez (1996) predict tobacco-related deaths in low income countries will more than quadruple. But the large number of current smokers in the formerly socialist economies and the established market economies means that tobacco control efforts in these countries remain critical for public health. For example, although smoking rates have substantially fallen in the U.S., smoking remains the leading preventable cause of death, contributing to 435,000 deaths annually (Mokdad et al. 2004). The European Partnership to Reduce Tobacco Dependence (2001) observes that: "Unless more is done to help the 200 million European adult smokers stop, the result will be 2 million European deaths a year by 2040." Our project will be conducted in two phases to better understand the nature and effect of tobacco control policies on life-cycle smoking behavior. In Phase I we will generate and use life-course smoking histories of individuals to describe and compare patterns of smoking behavior in ten developing and developed economies, including four formerly socialist economies. For each country we will differentiate patterns of life-course smoking of men and women of different birth cohorts. We will frame the patterns in each country by key events related to tobacco consumption. In Phase II we will estimate behavioral models of smoking initiation and cessation using individual life-course smoking histories merged with policy information over the same time period. We will also analyze broad patterns of smoking behavior for each cohort (age began to smoke, age when quitting begins to exceed initiation). In this part of the project we will use multi-variate estimation methods to identify causal effects of policies on smoking behavior in each country. We will also compare patterns in smoking behavior and patterns in estimated effects of policies across all ten countries to identify broad similarities and differences. The comparison across countries will not only inform our current understanding of smoking behavior and the effects of policies on smoking behavior, it will also generate new hypotheses and directions for future research to pursue.

Public Health Relevance

In the project "Cross-National Patterns and Predictors of Life-cycle Smoking Behavior" we will document and describe patterns in smoking behavior of men and women in ten developed and developing countries. We will detail how smoking behavior has evolved across the life-course of multiple generations in each country placing key historical events in their lives. We will also estimate how decisions to start and stop smoking vary with the tobacco control policies each country has used.

Agency
National Institute of Health (NIH)
Type
Research Project (R01)
Project #
5R01AG030379-04
Application #
8309177
Study Section
Community Influences on Health Behavior (CIHB)
Program Officer
Haaga, John G
Project Start
Project End
Budget Start
Budget End
Support Year
4
Fiscal Year
2012
Total Cost
Indirect Cost
Name
Cornell University
Department
Social Sciences
Type
Sch of Home Econ/Human Ecology
DUNS #
872612445
City
Ithaca
State
NY
Country
United States
Zip Code
14850
Lillard, Dean R; Christopoulou, Rebekka; Gil Lacruz, Ana (2014) Re: "Validation of a method for reconstructing historical rates of smoking prevalence". Am J Epidemiol 180:656-8
Christopoulou, Rebekka; Han, Jeffrey; Jaber, Ahmed et al. (2011) Dying for a smoke: how much does differential mortality of smokers affect estimated life-course smoking prevalence? Prev Med 52:66-70