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CENTURY
Yale University
School of Medicine
SAC-203
Connecticut
Mental Health Center
34 Park Street
New Haven, CT 06519

Phone:
203-974-7591

Fax:
203-974-7606

E-mail:
infocentury@yale.edu

Support for this web site was provided, in part, by a grant from
The Robert Wood Johnson Foundation® Princeton, New Jersey

Policy Projects

The tobacco related policy research unit at the Yale School of Public Health has several projects ongoing. They include one on smoking and productivity, another on a cost effectiveness analysis of innovative treatment and a third on cessation efforts and health in an older population.

December Research & Policy Brief

Research findings on two related topics – additional benefits to quitting, and risk factors for failing to quit – can serve as the basis for developing more effective public and work-place policies to motivate and help smokers to quit.  In our December 2006 Research & Policy Brief, We provide empirical evidence regarding smoking cessation using large nationally representative data sets, often of older long-term smokers.

Smoking and productivity

We examine the impact of smoking, quitting, and quantity/frequency of smoking on workplace productivity. We use several measures of productivity, including: absences, wages, hours worked, and retirement. We also examine how the impact of smoking on productivity interacts with state laws regarding tobacco control. We also analyze how individual decisions about smoking and quitting are affected by both work place and state level controls. Our work is empirically based. We use several large, nationally representative data sets. These include the Tobacco Supplements of the Current Population Survey, the Community Tracking Survey, the Health and Retirement Study, and the National Longitudinal Alcoholism and Epidemiology Survey.

Results from our research will benefit various groups of society. Employers and other institutions may be motivated to offer smoking cessation programs and therefore benefit from reduced absenteeism, greater productivity per hour worked, reduced disability and workmen's compensation expenses, and a more stable work force (e.g. reduced turnover). Governments may improve access to smoking cessation programs resulting in increased GDP and reductions in welfare payments. Workers who smoke and their families would share in these benefits as well.

Cost effectiveness analysis (CEA) of innovative treatment

The purpose of this study is to conduct a cost-effectiveness analysis of the use of both naltrexone and the transdermal nicotine patch (naltrexone plus patch) for smoking cessation treatment, as compared to the patch alone. We will utilize data from the Yale TTURC's clinical trial of the efficacy of naltrexone when combined with the patch (Stephanie O'Malley, P.I.). We will have detailed data on numerous aspects of the approximately 400 individuals in the trial. Information includes, smoking, alcohol use, and symptoms of depression, in addition to socio-economic and demographic information.

In addition to using the traditional approach to valuing quits as an outcome, we use a novel approach. We will use contingent valuation surveys to elicit individuals' willingness to pay for alternative smoking cessation programs that vary in both effectiveness rates and side effects (including weight gain). This method will allow us to better understand the market for cessation treatments beyond the status quo. In particular, we can examine the value of hypothetical rates of effectiveness and magnitude of side effects, especially weight gain.

Cessation efforts and health in an older population

In this study, we use large secondary data sets to provide empirical information on the interplay among risk-factors for long-term smokers who have found it hard to quit smoking. Older smokers have demonstrated difficulty quitting, have high risk factors of health problems, are female in a large proportion, and may have symptoms of depression and use alcohol. They are likely to be long-term smokers.

We use a nationally representative longitudinal survey, the Health and Retirement Study (HRS) to examine these long-term smokers. The ability to track health, smoking, and workplace productivity across the waves of data enable us to effectively deal with issues of causality. We have several projects, all aimed at understanding which characteristics play a role in motivating older smokers to quit. One analyzes how health status and changes in health status affects an individual's decision to stop smoking and their success. Another examines whether reductions in smoking promote or discourage future cessation. Another seeks to identify policy mechanisms to affect change in older smokers, whether through medical care providers, Medicare or MCOs, family members, employers, etc.

The tobacco related policy research unit at the Yale School of Public Health is funded by The Robert Wood Johnson Foundation and works closely with the Transdisciplinary Tobacco Use Research Center.