Philip Morris International R&D, Philip Morris Products S.A, Quai Jeanrenaud 5, 2000, Neuchatel, Switzerland.
P. N. Lee Statistics and Computing Ltd, 17 Cedar Road, Sutton, SM2 5DA, United Kingdom.
Regul Toxicol Pharmacol. 2018 Aug;97:88-97. doi: 10.1016/j.yrtph.2018.06.001. Epub 2018 Jun 9.
Reduced Risk Products (RRPs) do not burn tobacco and produce lower levels of toxicants than in cigarette smoke. The long-term effects of using RRPs on health are difficult to assess in a pre-market setting and a modeling approach is required to quantify harm reduction. The Population Health Impact Model (Weitkunat et al., 2015) follows a hypothetical population of individuals over time, creating their tobacco use histories and, based on these, estimating relative and absolute risks of lung cancer, ischemic heart disease, stroke and chronic obstructive pulmonary disease. Linking the tobacco use to the risk profile allow us to assess how the relative and absolute risks of these diseases vary between individuals aged 20, 30, 40 or 50 at baseline who have never smoked or who initiated smoking at 19 years old and either continued to smoke, quit smoking, or switched to RRPs with varying degrees of harm reduction. The simulations suggest that, for smokers in their 20s-30s quitting, or switching to RRP primarily prevents the accrual of risk, while in their 40s-50s it reduces risk. Though tobacco prevention has been the primary approach to limit smoking-related diseases, RRPs can also substantially reduce risks in individuals who do not quit.
减害产品（RRPs）不燃烧烟草，产生的有毒物质水平低于香烟烟雾。在上市前评估使用 RRPs 对健康的长期影响是困难的，需要采用建模方法来量化减害效果。人口健康影响模型（Weitkunat 等人，2015 年）追踪了随时间推移的假想人群，构建他们的烟草使用史，并基于这些历史来估计肺癌、缺血性心脏病、中风和慢性阻塞性肺疾病的相对和绝对风险。将烟草使用与风险概况联系起来，使我们能够评估在基线时从未吸烟或 19 岁开始吸烟且持续吸烟、戒烟或转向不同减害程度的 RRPs 的人群中，20 岁、30 岁、40 岁或 50 岁的个体之间这些疾病的相对和绝对风险如何变化。模拟结果表明，对于 20 多岁到 30 多岁的吸烟者来说，戒烟或转向 RRPs 主要可以防止风险的累积，而对于 40 多岁到 50 多岁的吸烟者来说，它可以降低风险。尽管烟草预防一直是限制与吸烟相关疾病的主要方法，但 RRPs 也可以在不戒烟的个体中大幅降低风险。
