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. 2015 Jul 28;12(7):e1001856. doi: 10.1371/journal.pmed.1001856

Table 1. Input parameters.

Parameter Comment Trend, Uncertainty, and Any Scenario Analyses
Baseline
Population Statistics New Zealand (SNZ) population estimates for 2011 by sex, age group, and ethnicity. Nil uncertainty.
All-cause mortality rates SNZ mortality rates by sex, age, and ethnicity for 2011. Trend is equal to the weighted sum (weights = proportion of deaths in 2011, by sex, age, and ethnicity) of trends for each explicitly modeled disease (i.e., [incidence] + [case-fatality]–[remission]), and the remaining causes of death are consistent with long-run mortality trends [24] (annual 2.25% mortality decline for Māori and 1.75% per annum for non-Māori). Trends were modeled out to 2026, with 0% per annum decline for both ethnic groupings thereafter. Uncertainty: nil. Scenario analysis: extend trends indefinitely out beyond 2026.
Disease-specific incidence, prevalence, and case-fatality rates (and remission rates) For each tobacco-related disease, coherent sets (by sex, age, and ethnicity) of incidence rates, prevalence, case-fatality rates (CFR), and remission rates (zero for noncancers, the complement of the CFR for cancers to give the expected 5-y relative survival) were estimated using DISMOD II [22]. Cancer incidence and CFR annual percentage change (APC) trends based on historic trends [25,26], projected out to 2026, then constant. (Future prevalence changes dynamically with model.) Uncertainty: Starting in 2011, rates all +/- 5% SD, correlations 1.0 between four sex × ethnic group categories for all diseases. APC all +/- 0.5% SD normal, correlations 1.0 between 4 sex × ethnic groups for all diseases. Scenario analyses: extend trends indefinitely out beyond 2026; halve and double SD uncertainty.
Total morbidity per capita in 2011 The per capita rate of years of life lived with disability (YLD) from the NZBDS [23] by sex, age, and ethnicity. No trend (i.e., assumed constant into the future). Uncertainty +/- 10% SD log-normal. Scenario analysis: halve and double SD uncertainty.
Disease morbidity rate per capita Each disease was assigned a disability rate (DR; by sex and age) equal to YLDs for that disease (scaled down to adjust for comorbidities) from the 2006 NZBDS [23] projected forward to 2011, divided by the disease prevalence (above). This DR was assigned to the proportion of the cohort in each disease state. No trend. Uncertainty: +/- 10% SD normal. Scenario analysis: halve and double SD uncertainty.
Health system costs Linked health data (hospitalizations, inpatient procedures, outpatients, pharmaceuticals, laboratories, and expected primary care usage) for each individual in New Zealand (NZ) for the period 2006–2010 had unit costs assigned to each event, and then five health system costs (NZ$2011; by strata of sex and age) were estimated (see S2 Text). No trend. Uncertainty: +/- 10% SD log-normal. Scenario analysis: halve and double SD uncertainty.
Tobacco smoking prevalence As in the 2013 NZ census, back-estimated to 2011 using annual net cessation and initiation rates and allowing for tax in 2011 to 2013 (using price elasticities detailed below). BAU calculated using 2006 to 2013 census-derived trends in initiation and net cessation rates (stripped of “tax effect”) [16], projected out to the future.
Annual proportionate reductions in initiation age 20:
- Non-Māori: male 0.0339, female 0.0276
- Māori: male 0.0288, female 0.0322
Uncertainty: +/- 20% SD beta correlations 1.0 between four sex × ethnic groups. Scenario analysis: halve and double SD uncertainty.
Annual net cessation rates:
20–34 y of age:
- Non-Māori: male 0.0414, female 0.0554
- Māori: male 0.0393, female 0.0451
35–54 y of age:
- Non-Māori: male 0.0384, female 0.0431
- Māori: male 0.0369, female 0.0472
55+ y of age:
- Non-Māori: male 0.0722, female 0.0714
- Māori: male 0.0769, female 0.0699
Uncertainty: +/- 20% SD beta, correlations 1.0 between 12 sex × age × ethnic group categories. Scenario analysis: halve and double SD uncertainty.
Intervention
Cost of a law Cost of a new law in NZ to mandate the series of annual tax rises, NZ$3.54 million [27]. Uncertainty: gamma SD NZ$1.05 million in 2011 only
Excise tax increase 10% Annually from 2011 to 2031, with scenario analyses about number of years. Uncertainty = +/- 10% (or 1 percentage point of 10% excise tax) SD normal. Scenario analyses: halve and double SD uncertainty.
Tobacco tax price elasticities Non-Māori: Price elasticities of -0.38 (for 15–20-y-olds), -0.29 (for 21–24-y-olds), -0.19 (for 25–34-y-olds), and -0.10 (for 35+ y-olds) for smoking prevalence were applied in the year the tax rise was implemented [5,16,28]. Māori: Within each iteration, we scaled up the non-Māori price elasticity by 20% for Māori, given economic theory, the patterns in the international literature for other social groupings [3,29], and some New Zealand evidence for increased price sensitivity for Māori [30,31]. No trend. Uncertainty: non-Māori, +/- 20% normal, correlated 1.0 across four age groups; Māori absolute scalar of +20% within each age group, +/- 10% normal (i.e., 95% range of absolute scalar of 0.4% to 39.6%). Scenario analyses: no ethnic scalar; halve and double SD uncertainty.
Relative risks for smoking and disease incidence Relative risks of disease incidence for the association of current (or ex-smoker) with never smoker were sourced from NZ linked census-cancer [21] and census-mortality [32] (censuses include smoking question) and CPS II data for respiratory diseases [33]. Attenuation over time since quitting for ex-smokers was modeled using equations and coefficients from Hoogenveen et al. [34]. Standard errors of regression coefficients as published (and in S2 Text—log-normal). Scenario analyses: using higher cancer prevention study 2 (CPS II) relative risks (RRs) for coronary heart disease (CHD) and stroke, compared to NZ RRs; double SD.