How to Obtain Long Term Projections for Smoking Behaviour A Case Study in the Dutch Population.pdfVIP

Computational and Mathematical Methods in Medicine Vol. 10, No. 2, June 2009, 155–164 How to obtain long term projections for smoking behaviour: A case study in the Dutch population ab b c Maurizio Capannesi *, Hendriek C. Boshuizen , Marc C. Willemsen and Hans C. van Houwelingenab aDepartment of Medical Statistics and Bioinformatics, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands; bExpertise Centre for Methodology and Information Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; cSTIVORO for a Smoke Free Future, Expertise Centre on Tobacco Control, Den Haag, The Netherlands A state-transition model is presented to project the prevalence rates of never, current and former smokers within the Dutch population. Changes are determined by the transition rates among these three classes: start rates, quit rates and relapse rates. Both the initial prevalence rates and transition rates are calculated from cross-sectional data using a restricted quadratic multinomial regression spline and a restricted quadratic logistic regression spline, respectively. Through a Monte Carlo experiment an uncertainty analysis was performed to assess the level of reliability of the results, while a sensitivity analysis was carried out in order to detect the input variables that mostly contribute to the output variability. The results obtained through this model show a considerable but rather slow decrease of smokers up to year 2050. Keywords: state transition models; restricted quadratic regression spline model; smoking prevalence rates; transition r