Development of Smoking Behavior in Adolescence: the Case of North Dakota
- Publisher: The University of Bergen
smoking development | anti-tobacco policy | system dynamics | adolescents | 733199 | e-cigarettes | Mastergrad | nicotine dependence level
mesheuropmc: education | health care economics and organizations
This thesis describes a modeling project,
performed by Oleksandr Ivanov, a student
enrolled in European Master Program in System
Dynamics, in cooperation with assistant
professor Arielle Selya (University of North
Dakota) and under the supervision of associate
professor I. David Wheat (University of
The fieldwork was conducted in Grand Fork,
North Dakota, the USA in April-June 2015.
The main problem is devoted to the prevalence
in smoking cigarettes among adolescents (middle
school and high school students) in North
Dakota. Despite the comprehensive anti-tobacco
policies implemented since 1998, more than 20%
of high school students are still exposed to a
smoking habit. Among the reasons for this are
high nicotine dependence level and the low
state excise tax for tobacco products.
The thesis provides an overview of main driving
forces and feedbacks within the system of
smoking development, pointing out peer and
parental pressure, nicotine dependence and
other ambient factors (cigarette availability,
exposure to second-hand smoking, etc.).
Additionally, the research explores potential
consequences of the boom in the market of e-
cigarettes under different scenarios.
Particular focus is made on the policy analysis
and implementation, testing tax, informational,
compliance and ban on flavors policies towards
meeting Healthy People 2020 objectives. It was
found that the increase in the state tobacco
excise tax by 1.56 usd is the most promising
policy. If implemented in 2016, it would
benefit the society by 1381 lives saved from
the premature death and total saved costs of
1204 billion usd by 2032.
The thesis is structured as follows. Chapter 1
provides an introduction to the problem,
observes current trends in smoking, formulates
research objectives and research questions, and
discusses the research methodology. Chapter 2
describes the model structure in stock-and-flow
and causal loop perspectives. Chapter 3 tests
the initial hypothesis by model simulations.
Chapter 4 is devoted to the process of model
validation. Chapter 5 suggests policy options,
analyses their cost-effectiveness, and provides
a detailed action plan.