본 연구에서는 건강행태의 변화에 따른 질병 예측 및 질병부담 추계를 위한 마이크로시뮬레이션 모델을 구축하여, 건강행태 중 흡연율이 감소하였을 때 질병 발생과 질병 부담이 어떻게 달라질 것인지 추정하였다.
Microsimulation models can be powerful tools for assessing value of health promotion and simulating counterfactual scenarios. We illustrate with a microsimulation model of reduced male smoking in South Korea, which has one of the highest male smoking rates in the world despite a recent decline.
Drawing from the nationally-representative Korean Longitudinal Study on Aging, we developed the South Korean Future Elderly Model, a dynamic micro-simulation model. We simulated three types of interventions that reduce the cumulative number of packs of cigarettes that a man smoked before age 50: a 30% overall reduction, eliminating smoking among light smokers (bottom 30th percentile of smoking intensity), or among heavy smokers (top 70th percentile).
All three interventions led to significant improvements in health, with that targeting the heaviest smokers yielding gains of 2.36 life years, 1.4 disability-free life years and 1.63 disease-free life years, as well as significant reductions in prevalence of cancer, diabetes, heart disease, hypertension, lung disease and stroke. An across-the-board 30% reduction in smoking intensity resulted in an increase in life expectancy of 1.16 years, an increase of 0.83 disability-free life years, an increase of 0.28 disease-free life years, and a reduction in cancer prevalence. Eliminating smoking among light smokers yielded few health gains.
For tobacco control to significantly raise life expectancy and reduce the chronic disease burden among the future elderly in South Korea, interventions should target heavy smokers.
목차
Abstract 1 요 약 3 제1장 서 론 5 제1절 연구의 배경 7 제2절 연구의 목적 10 제2장 모델 구축 13 제1절 개요 15 제2절 이행 모델 추정(Transition model estimation) 21 제3절 몬테카를로 의사결정 22 제4절 데이터 및 추정 결과 23 제3장 정책 시뮬레이션 29 제1절 인구고령화에 따른 유병률 전망 31 제2절 흡연율 감소의 질병부담 영향 35 제4장 시뮬레이션 결과 및 결론 37 제1절 시뮬레이션 결과 39 제2절 결론 45 참고문헌 49
