Tobacco smoking is strongly linked to chronic obstructive pulmonary disease (COPD), a common, debilitating disease related to the lungs. Policies that discourage people from starting to smoke and encourage people to quit smoking are likely to improve public health by reducing the amount of people with COPD. However, which policies to implement is a decision that needs to be supported by research. A Health Impact Assessment is one method to evaluate and measure how a policy intervention can impact behaviour and improve public health.
As part of the "Ageing Lungs in European Cohorts" (ALEC) study, this project will use a Health Impact Assessment approach to assess how price increases in tobacco may reduce the amount of people who smoke, and consequently, the COPD burden over a 40-year timeframe in three European countries (Italy, Sweden and the United Kingdom). Information on population demographics and smoking behaviour will be country-specific and obtained from local sources. Information on the current burden of COPD will be obtained from the Clinical Practice Research Datalink (CPRD) records and applied to all three countries, given the large size and coverage of the CPRD resource and the lack of equivalent country-specific data available for use by the applicants.
Using the Health Impact Assessment tool "DYNAMO-HIA" and data from Italy, Sweden and the United Kingdom, we will quantify the reductions in future COPD prevalence and incidence that would occur over a 40-year time frame if tobacco prices increased by 25% and 50%, compared to a business-as-usual scenario. DYNAMO-HIA uses a Markov-based modelling approach to model age and sex group specific probabilities of staying or moving to a risk factor (smoking) group under certain scenarios, and quantifies how this affects future risk factor (smoking) and disease (COPD) trends.
Demographic and smoking behaviour information will be country-specific and obtained from local resources. COPD disease data will be obtained from the CPRD and used for all three countries. The CPRD study population will consist of a 1 million person random sample of patients 6 - 95 years-old contained within the CPRD record between 01/01/ 2015 and 31/12/2017. Doctor diagnosed COPD prevalence, incidence, excess mortality and 1-year mortality rates will be calculated and inputted into DYNAMO-HIA alongside demographic and smoking behaviour information.
This work, a part of the ALEC study, will inform policies aimed at reducing smoking rates and their impact on the burden of COPD.
Overall mortality
- COPD 1-year mortality rate
- COPD excess mortality
- COPD incidence
- COPD prevalence
Jennifer Quint - Chief Investigator - Imperial College London
Elaine Fuertes - Corresponding Applicant - Imperial College London
Alicia Gayle - Collaborator - Imperial College London
Cosetta Minelli - Collaborator - Imperial College London
Debbie Jarvis - Collaborator - Imperial College London
ONS Death Registration Data