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Georgia State University Tobacco Control of Regulatory Science (GSU TCORS)

The goal of the GSU TCORS titled “The Science of Decision-Making: Connection People and Policy” was to connect people and policy through an understanding of tobacco use and consumer decision-making. The GSU TCORS focused on examining how the diversity of tobacco products, risk perceptions of tobacco products, communications about tobacco products, tobacco product marketing, and economics and policies contribute to tobacco product use and decision-making.

The overarching aim of the projects led by the University of Illinois at Chicago is to produce new evidence to inform the FDA’s economic impact assessments of future proposed rules concerning use of tobacco products. This is done through a combination of behavioral economics experiments with original data collection, acquisition of existing archival, survey, and commercial databases, and merged data analyses that address the issues discussed above, as well as others that emerge in coming years.

The UIC Aim 1 assessed the impact of FDA regulatory actions on tobacco use and related outcomes by using a variety of secondary data from the US and other countries. The aim is to estimate the impact of existing, possible, and future FDA regulatory actions and other tobacco control policies on tobacco use and related outcomes. We have conducted several studies estimating the impacts of potential FDA regulatory actions, such as cigarette point-of-sale advertising bans, graphic warning labels, cigarette point-of-sale display bans on tobacco use among youths and adults. We used international data, such as GATS, GYTS, MPOWER, Euromonitor, and EIU, which provide information on tobacco use, tobacco control policies, tobacco market characteristics, nation’s economic characteristics from different countries. We found that potential FDA regulatory actions, such as cigarette point-of-sale advertising bans and graphic warning labels significantly reduced smoking prevalence and cigarette consumption for both youth and adults. Graphic warning labels that cover 50% of package significantly reduces smoking prevalence and cigarette consumption among adult population, and the effects are particularly large and significant among low educated subgroup. The overall MPOWER scores that measured tobacco control policy implementation in each domain significantly reduce smoking prevalence and consumption.

The UIC Aim 2 used the behavioral economics experiments to assess the impact of FDA regulatory actions on the consumer surplus obtained by tobacco users, with an emphasis on understanding how tobacco users value the role of regulations/policies in enhancing self-control and in supporting efforts to quit. Of particular interest is the time inconsistencies of present bias and projection bias displayed in smokers’ decisions about tobacco use.

Questions on hypothetical rewards redeemed at different time points in the 2016 Tobacco Products and Risk Perceptions Survey were used to assess individual’s time preference (individual discount rate and hyperbolic discounting). Studies examine the association of smoking with two aspects of personal time discounting (1) impatience, measured by personal discount rate; (2) hyperbolic discounting, where a person with self-control problem who is less patient in immediate than distant future choices. Our findings indicate that being a smoker, lower educational attainment, and lower income is associated with a higher personal discount rate, indicating these subgroups are less patient and more heavily discount future consequences. Similarly, being a smoker, lower education attainment, and lower income is associated with a higher likelihood of being a hyperbolic discounter, indicating their decision making are present biased and have self-control problem.

Findings from these analyses are critical to improving understanding about how tobacco control policies and regulations change consumer surplus and affect the net benefits that result from these actions.

The UIC Aim 3 assessed the economic impact of FDA regulatory actions by extending the range of costs and benefits. We used existing data to expand the set of costs and benefits considered in FDA’s economic impact analysis of cigarette warnings. We included the benefits that accrue from reductions in nonsmokers’ exposure to cigarette smoke and maternal smoking during/after pregnancy, the longer term benefits resulting from increased cessation and reduced initiation, the broader economic benefits resulting from reduced prevalence of tobacco use, and other cost and benefit categories.

We quantified the national hospital cost savings from the reductions in prenatal smoking that will arise if GWLs are implemented in the US. We used several data sources to estimate the impact of prenatal smoking on the likelihood of having a low-birth-weight baby, controlling for socio-economic and demographic characteristics as well as medical and non-medical risk factors. Using these estimates, we calculated the change in the number of LBW babies resulting from decreased prenatal smoking due to GWLs. Using this estimated change, we calculate cost saving that arises from reduced prenatal smoking in response of GWLs. Our results indicated that GWLs for this population could lead to hospital cost savings of 1 billion to 1.7 billion dollars over a 30 year horizon.