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Introduction Smoking remains the leading cause of preventable death in the USA but can be reduced through policy interventions. Computational models of smoking can provide estimates of the projected impact of tobacco control policies and can be used to inform public health decision making. We outline a protocol for simulating the effects of tobacco policies on population health outcomes. Methods and analysis We extend the Smoking History Generator (SHG), a microsimulation model based on data from the National Health Interview Surveys, to evaluate the effects of tobacco control policies on projections of smoking prevalence and mortality in the USA. The SHG simulates individual life trajectories including smoking initiation, cessation and mortality. We illustrate the application of the SHG policy module for four types of tobacco control policies at the national and state levels: smoke-free air laws, cigarette taxes, increasing tobacco control programme expenditures and raising the minimum age of legal access to tobacco. Smoking initiation and cessation rates are modified by age, birth cohort, gender and years since policy implementation. Initiation and cessation rate modifiers are adjusted for differences across age groups and the level of existing policy coverage. Smoking prevalence, the number of population deaths avoided, and life-years gained are calculated for each policy scenario at the national and state levels. The model only considers direct individual benefits through reduced smoking and does not consider benefits through reduced exposure to secondhand smoke. Ethics and dissemination A web-based interface is being developed to integrate the results of the simulations into a format that allows the user to explore the projected effects of tobacco control policies in the USA. Usability testing is being conducted in which experts provide feedback on the interface. Development of this tool is under way, and a publicly accessible website is available at http://www. tobaccopolicyeffects. org. [ABSTRACT FROM AUTHOR]

Background Namibia is typical of low-income and middle-income countries with growing tobacco use, but with limited capacity to impose comprehensive tobacco control legislation. Despite initiating dialogue on national tobacco control policy in 1991, the country took nearly 20 years to pass the Tobacco Products Control Act. Objective To use Namibia as a case study to illustrate challenges faced by low-income countries working to forward tobacco control legislation. Method Face-to-face and telephonic interviews were conducted with 13 bureaucrats and advocates currently or previously engaged in tobacco-related work in Namibia. Tobacco-related news articles from national newspapers were examined. Results The constitutional obligation of the government to promote public health laid the foundation for Namibia’s tobacco control policy. Staff capacity constraints greatly delayed the passing of tobacco control legislation. It is unclear what influence the tobacco industry's involvement as a stakeholder had on policy; however, in at least one instance, the tobacco industry actively misled government. Namibia’s ratification of the Framework Convention on Tobacco Control was instrumental in passing legislation that meets most provisions of the international treaty. The media have generally played a supportive role in pushing the government to pass tobacco control legislation. Conclusions The fact that Namibia was able to pass fairly comprehensive tobacco control legislation with such meagre resources is commendable. The government must now implement the regulations that make the legislation effective. Tobacco control progress in low-income and middle-income nations can be encouraged through use of the media and improved staff and legal capacity within health ministries. [ABSTRACT FROM AUTHOR]

Background Research has contributed significantly to tobacco control in high-income nations, but has not yet played a comparable role in low- and middle-income countries (LMIC). In recent years, efforts have been devoted to building research capacity in LMICs. Using publication in Tobacco Control as a proxy for all tobacco control research, we examine whether research articles authored by scholars from LMICs and about LMIC issues have increased over the Journal's history. Methods We examined every issue of Tobacco Control from 1992 to 2011, coding contributions as to their authorship (LMIC, high-income country, or both), and whether they covered tobacco control issues in LMICs. We included all the following journal categories: Original/Research articles, Brief reports, Reviews, Letters to the editor, Special communications, Commentaries, and Editorials. Results We divided the Journal's first 20 years into four 5-year periods. There was no statistically significant change in LMIC authorship or LMIC issue coverage during the first three periods. From those three periods combined (1992-2006), to the most recent 5-year period (2007-2011), articles including any LMIC authors increased from 7.2% to 22.7% ( p<0.05) of all original research articles; lead authorship by LMIC scholars increased from 4.0% to 13.7% ( p<0.05); and coverage of LMIC issues rose from 10.1% to 30.9% ( p<0.05). Similar findings resulted when combining all the journal categories. Conclusions Efforts to expand research by LMIC authors and about LMIC issues have begun to bear fruit, with a recent substantial increase. Still, the centrality of LMICs in the global tobacco pandemic implies that this progress only begins to address the enormous need. [ABSTRACT FROM AUTHOR]

Objectives: To assess progress in tobacco control policy research and the relevance of research to policymaking. Methods: Over 100 experts were surveyed about their opinions on the body of research existing in 1992 and 2011 concerning 11 areas of tobacco control policy, the state of policy implementation in both years, the extent to which research has affected policy adoption and how experience with policy has influenced research. Case studies of how research and policy implementation have interacted were developed. Results: The body of research was not judged 'substantial' in any of the policy areas in 1992. In 2011, 6 of the 11 areas were evaluated as substantial. None ranked as substantial regarding policy implementation in 1992, but by 2011 half were so ranked for developed countries; in low-income and middle-income countries policy implementation moved from very low to moderate. Respondents judged the role of research in actual policymaking as 'substantial' regarding clean indoor air, taxation and cessation treatment policy. Case studies illustrate how research can directly affect policy (taxation), how policy and research can have iterative effects (clean indoor air), and how research and policy interact in the case of novel policies (graphic cigarette pack warnings). The role of research in the formulation of the Framework Convention on Tobacco Control is also examined. Conclusions: Policy research goals established in 1992 have been largely realised. For select tobacco control policies, research has made truly important contributions to saving lives. Evidence-based policy adoption will continue to be essential to minimising the toll of tobacco, especially in the world's poorer countries. [ABSTRACT FROM AUTHOR]