Application of a System Dynamics Model to Inform Investment in Smoking Cessation Services in New Zealand

Objectives. We estimated the long-term effects of smoking cessation interventions to inform government decision-making regarding investment in tobacco control. Methods. We extracted data from the 2006 New Zealand Tobacco Use Survey and other sources and developed a system dynamics model with the iThink computer simulation package. The model derived estimates of population cessation rates from smoking behaviors and applied these over a 50-year period, from 2001 to 2051, under business-as-usual and enhanced cessation intervention scenarios. Results. The model predicted larger effects by 2051 with the enhanced cessation than with the business-as-usual scenario, including: an 11% greater decline in adult current smoking prevalence (9 versus 10 per 100 people), 16% greater decline in per capita tobacco consumption (370 versus 440 cigarette equivalents per year), and 11% greater reduction in tobacco-attributable mortality (3000 versus 3300 deaths per year). Conclusions. The model generated reliable estimates of the effects on health and on tobacco use of interventions designed to enhance smoking cessation. These results informed a decision announced in May 2007 to increase funding for smoking cessation by NZ$42 million over 4 years. (Am J Public Health. 2010; 100:1274-1281. doi:10.2105/AJPH.2009.171165)