Modeling the population health effects of Camel snus with reduced risk information
We present findings from a statistical model, used to assess the population health effects of Camel Snus with reduced risk information. Analyses followed a single cohort of 1 million males from age 13 to age 72, comparing the number of survivors in a base case (cigarette use only) to a counterfactual scenario (cigarette or Camel Snus use). Age-specific likelihoods that relevant groups – smokers who otherwise would quit, smokers who otherwise would continue smoking, non-tobacco users who otherwise would initiate smoking, and non-tobacco users who otherwise would remain non-users – would use Camel Snus with reduced risk information were derived from consumer testing that projected purchase probabilities; secondary transitions, such as potential gateway effects for Camel Snus, used conservative probabilities. Analyses that considered all beneficial and harmful transitions estimated that increased Camel Snus use would improve survival by ~7,000 individuals (assuming 89-92% risk reduction, versus smoking); and, a survival benefit would be retained if Camel Snus reduced risk by as little as 55%, compared to smoking. Extrapolation of the estimated survival benefit to a realistic U.S. cohort of 4.1 million (both genders), suggests survival to age 72 years would be increased by >25,000 individuals. Tipping point analyses that included all primary and secondary harmful transitions indicated that if ~1.5% of continuing smokers switched completely and persistently to Camel Snus at each age interval, there would be a survival benefit. These single cohort analyses demonstrate that the transition with the greatest effect on population health is complete switching among smokers who otherwise would continue smoking. Collectively, these analyses indicate that providing reduced risk information for Camel Snus is likely to have a beneficial effect on overall population health.