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Economic Aspects of Waterpipe Tobacco Smoking. Scott E. Sherman, MD, MPH Co-Chief, Section on Tobacco, Alcohol and Drug Use Associate Professor of Population Health, Medicine and Psychiatry New York University School of Medicine Staff Physician, VA New York Harbor Healthcare System.
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Economic Aspects of Waterpipe Tobacco Smoking Scott E. Sherman, MD, MPH Co-Chief, Section on Tobacco, Alcohol and Drug Use Associate Professor of Population Health, Medicine and Psychiatry New York University School of Medicine Staff Physician, VA New York Harbor Healthcare System
Objectives • To review scientific knowledge about business and economics aspects of waterpipe tobacco use • To outline future research needs
To review scientific knowledge about economics of waterpipe tobacco use
To review scientific knowledge about economics of waterpipe tobacco use
Business and economic aspects - Why do we care? • Impact at different levels • Society • Business • Health system • Individual • Evidence-based policy (Intelligent)
A global market for hookah Phoenix, AZ Moscow Beijing Tampa, FL
Map of NYC Hookah Bars Listed on Yelp.com US CDC web site: An estimated 300 hookah cafés operated in the United States in 2006 Yelp: 130 businesses are listed on Yelp with a tag “hookah Bars” within New York City in 2013 Mapping tool is publicly available on UCLA Geomapping Lecturer Yoh Kawano’s educational website.
Business of hookah – Research questions • Producers, suppliers • Which countries • Small businesses or large multinationals • Sellers • Hookah bars vs. sales for home use
Economics of waterpipe tobacco • Internal costs – costs to user (and in some cases to his/her family) • External costs – costs to others • Businesses • Health care system • Societal costs = internal + external costs
Estimated annual US costs of cigarette smoking Sloan FA et al. The Price of Smoking. 2004, MIT Press.
Estimated annual US costs of cigarette smoking Questions Do hookah smokers have increased health care utilization? Do hookah smokers have increased health care costs? What fraction of CVD, CA, etc. is attributable to hookah?
Estimated annual U.S. costs of cigarette smoking Questions How much do hookah smokers spend on waterpipe smoking?
Estimated annual U.S. costs of cigarette smoking Questions Do waterpipe smokers have more sick days? Does waterpipe smoking decrease productivity at work? Does waterpipe smoking affect quality of life (short & long term)?
Estimated annual U.S. costs of smoking Questions Does waterpipe smoking increase mortality rates? If so, how many years of life do waterpipe smokers lose?
Modeling • Price elasticity • Salience – how to make it more relevant • Cost-effectiveness of cessation interventions
NYU Global Institute of Public Health Capstone Project Team • Survey of hookah bar owners in New York, Abu Dhabi and Dubai – starting in December
And just when we are beginning to study the market… …the market is changing
Research agenda for the next 5 years • What fraction of morbidity and mortality is attributable to waterpipe tobacco? • What existing national and international surveys include both questions on hookah and economics? Also, need to include hookah questions in future surveys. • Understand economics of restaurants/hookah bars • Understand supply chain, costs, profitability • Understand individual costs/benefits/preferences • Price elasticity • Compiled data • Individual modeling
