Developing a theory of the societal lifecycle of cigarette smoking : explaining and anticipating trends using information feedback
Cigarette smoking presented the most significant public health challenge in the United States in the 20th Century and remains the single most preventable cause of morbidity and mortality in this country. A number of System Dynamics models exist that inform tobacco control policies. We reviewed them and discuss their contributions. We developed a theory of the societal lifecycle of smoking, using a parsimonious set of feedback loops to capture historical trends and explore future scenarios. Previous work did not explain the long-term historical patterns of smoking behaviors. Much of it used stock-and-flow to represent the decline in prevalence in the recent past. With noted exceptions, information feedbacks were not embedded in these models. We present and discuss our feedback-rich conceptual model and illustrate the results of a series of simulations. A formal analysis shows phenomena composed of different phases of behavior with specific dominant feedbacks associated with each phase. We discuss the implications of our society's current phase, and conclude with simulations of what-if scenarios. Because System Dynamics models must contain information feedback to be able to anticipate tipping points and to help identify policies that exploit leverage in a complex system, we expanded this body of work to provide an endogenous representation of the century-long societal lifecycle of smoking.