Development and validation of the Tobacco Use Individual-level Simulation and Tracking (TwIST) Model
Year: 2026
Type: article
Abstract: Simulation models of tobacco use behavior are useful analytic tools for projecting rates of tobacco use over time and identifying priority areas for intervention. This paper presents the Tobacco Use Individual-level Simulation and Tracking (TwIST) Model, an individual-based simulation model of tobacco use in the adult US population. We describe the model structure, data sources and parameters, and, in addition to future projections, compare modeled estimates of smoking prevalence to those from established surveys. The simulated population and model parameter estimates are informed by the Population Assessment of Tobacco and Health Study and other nationally representative datasets. To simulate tobacco use over time, we estimated 2nd order Markov models using multinomial logistic regression. To validate the model, we compared model estimates of tobacco use to data from three national surveys. The model estimates adult cigarette smoking rates will decline from a prevalence of 12.4% (95% uncertainty interval (95% UI): 12.2-12.8%) in 2020 to 9.6% (95% UI: 9.3-9.9%), 9.1% (95% UI: 8.9-9.4%), and 8.7% (95% UI: 8.5-9.0%) in 2030, 2040, and 2050, respectively. From 2020 through 2050, adults living in poverty are estimated to have a cigarette smoking rate 2.1-2.3 times higher than individuals living above the poverty line. The prevalence of menthol cigarette use will decline at a slower rate than the prevalence of non-menthol cigarette use (21% vs. 38% decline). Model projections of cigarette smoking prevalence typically fall within the 95% confidence intervals of prevalence estimates across three national surveys. Overall, the TwIST Model projects cigarette smoking prevalence rates that are similar to real-world estimates. If tobacco use continues based on current patterns, income-based disparities in smoking will persist and a growing proportion of individuals who smoke will use menthol cigarettes, which are known to be harder to quit.
Source: PLoS ONE
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
Funders: Deanship of Scientific Research, Imam Mohammed Ibn Saud Islamic University, U.S. Department of Agriculture, Bill and Melinda Gates Foundation, American Heart Association, Asian Development Bank, Josiah Macy Jr. Foundation, University of Kansas, Japan Agency for Medical Research and Development, Royal College of Surgeons in Ireland, Innovative Research Group Project of the National Natural Science Foundation of China, European Chiropractors' Union, National Institute for Health and Care Research, Deutsche Forschungsgemeinschaft, University of Melbourne, National Natural Science Foundation of China, Ministerstvo Školství, Mládeže a Tělovýchovy, Grantová Agentura České Republiky, Bundesministerium für Bildung und Forschung, Science and Technology Commission of Shanghai Municipality, Gemeinnützige Hertie-Stiftung, Korea Health Industry Development Institute, National Research Foundation of Korea, Natural Science Foundation of Hubei Province, Iran National Science Foundation, Jordan University of Science and Technology, KU Leuven, King Fahd University of Petroleum and Minerals, Chinese Center for Disease Control and Prevention, Zhengzhou University, Deanship of Scientific Research, King Faisal University, Henan University, Natural Science Foundation of Liaoning Province, Natural Science Foundation of Chongqing, University of Kashan, Eesti Maaülikool, Rheinische Friedrich-Wilhelms-Universität Bonn, University of Sri Jayewardenepura, Foundation of Liaoning Province Education Administration, Région Hauts-de-France, Science and Technology Department of Henan Province, Longhua Hospital Shanghai University of Traditional Chinese Medicine, National Institutes of Health, National Institute of Food and Agriculture, Qatar National Research Fund, Qatar National Library, Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, National Health and Medical Research Council, Japan Society for the Promotion of Science, Public Health Research Programme, Japan Science and Technology Agency, National Key Research and Development Program of China, National Major Science and Technology Projects of China, Medizinische Fakultät, Rheinische Friedrich-Wilhelms-Universität Bonn, Guangxi Key Research and Development Program, Tianjin Science and Technology Program, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Cancer Institute, Fogarty International Center, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences, Core Research for Evolutional Science and Technology, H2020 European Research Council, FP7 Ideas: European Research Council, HORIZON EUROPE European Research Council, Trường Đại học PHENIKAA, University of Lincoln
Award: G1389395706
OpenAlex ID: W7128733342