Table 1.
Tobacco control policies, specifications and effect sizes applied in England SimSmoke.
| Policy | Description | Policy effect size |
|---|---|---|
| Cigarette excise taxes | ||
| Cigarette price/tax | The effect of taxes is directly incorporated through the average price after tax; the price elasticity is used to convert the price changes (%) into effect sizes | Elasticities |
| −0.4 for ages 14–17 | ||
| −0.3 for ages 18–24 | ||
| −0.2 for ages 25–34 | ||
| −0.1 for ages 35–64 | ||
| −0.2 for ages 65+ | ||
| Smoke-free air laws | ||
| Worksite smoking ban | Ban in all indoor worksites, with strong enforcement of laws (reduced by 1/3 if allowed in ventilated areas and by 2/3 if allowed in common areas) | −6% prevalence and initiation, +6% cessation |
| Restaurant smoking ban | Ban in all indoor restaurants (scaled for lower coverage), with strong enforcement of laws | −2% prevalence and initiation, +2% cessation |
| Pubs and bars smoking ban | Ban in all indoor in pubs and bars (scaled for lower coverage), with strong enforcement of laws | −1% prevalence and initiation, +1% cessation |
| Other place bans | Ban in 3 out of 4 government buildings (scaled for lower coverage), retail stores, public transportation and elevators, with strong enforcement of laws | −1% prevalence and initiation, +1% cessation |
| Enforcement and publicity | Government agency enforces the laws and publicity via tobacco control campaigns | Effects reduced 50% absent publicity and enforcement |
| Media campaigns | ||
| High level media campaign | Campaign publicized heavily with state and local programs with strong funding (>$0.50 USD) | −6.5% prevalence and initiation, +6.5% cessation |
| Medium level media campaign | Campaign publicized with funding of at least $0.10 USD per capita | −3.25% prevalence and initiation, +3.25% cessation |
| Low level media campaign | Campaign publicized only sporadically with minimal funding (< $0.10 USD per capita) | −1.63% prevalence and initiation, +1.63% cessation |
| Marketing restrictions | ||
| Comprehensive marketing ban | Ban on all forms of direct advertising including point of sale and indirect marketing | −5% prevalence, −8% initiation, +4% cessation |
| Moderate marketing ban | Ban on broadcast media, newspapers and billboards marketing and at least some indirect marketing (sponsorship, branding, giveaways) | −3% prevalence, −4% initiation, +2% cessation |
| Minimal marketing ban | Ban on broadcast media advertising | −1% prevalence and −1% initiation only |
| Enforcement | Government agency enforces the laws | Effects reduced 50% absent enforcement |
| Health warnings | ||
| Additional impact of plain packaging with strong health warnings | The outside of the package is drab, with brand and variant names appearing once on the front, top and bottom surfaces and no inserts | −2% prevalence, −2% initiation, +2% cessation |
| High health warnings | Labels are large, bold and graphic, and cover at least 50% of pack | −4% prevalence, −6% initiation, +10% cessation |
| Moderate health warnings | Laws cover at least 30% of package, not bold or graphic | −2% prevalence, −2% initiation, +4% cessation |
| Low health warnings | Laws cover <30% of package, not bold or graphic | −1% prevalence, −1% initiation, +2% cessation |
| Cessation treatment policies | ||
| Availability of pharmacotherapies | Legality of nicotine replacement therapy and/or bupropion and varenicline | −1% prevalence, +4% cessation |
| Cessation treatment financial coverage | Payments to cover pharmacotherapy and behavioural cessation treatment with high publicity (effect size reduced by 12.5% with moderate publicity and 18.75% with low publicity) | −2.25% prevalence, +8% cessation |
| Quit line | Three quit line types: passive, proactive and active with follow-up (effect size reduced by 1/3 if quit line is proactive, reduced by 2/3 if quit line passive) | −1% prevalence, +6% cessation |
| Brief interventions | Advice by health care provider to quit and methods provided | −1% prevalence, +6% cessation |
| All cessation policies combined | Complete availability and reimbursement of pharmaco- and behavioural treatments, quit lines and brief interventions | −5.68% prevalence, +29.4% cessation |
| Youth access policies | ||
| Strong enforcement and well publicized | Compliance checks conducted 4 times per year per outlet, penalties are potent and enforced with heavy publicity | −16% initiation and prevalence for ages 16–17 and −24% for ages 10–15 |
| Moderate enforcement with some publicity | Compliance checks conducted regularly, penalties are potent and publicity and merchant training are included | −8% initiation and prevalence ages 16–17 and −12% for ages 10–15 |
| Low enforcement | Compliance checks are conducted sporadically, penalties are weak | −2% initiation and prevalence ages 16–17 and −3% ages 10–15 |
Note: Unless otherwise indicated, the effects are in terms of the reduction in prevalence during the first year, the reduction in initiation and increase in quit rates during future years that the policy is in effect.