SAMMEC Update

1. SAMMEC Update Presented by Robert K. Merritt Office on Smoking and Health (CDC/OSH)

2. Goals • Describe methods for calculating ADULT SAMMEC • Data sources • Formulas • List Updates • Data sources and data modifications • Preliminary Results

3. Background • SAMMEC is an online software program used to estimate the hazardous health effects and economic costs of cigarette smoking • SAMMEC has two parts • Adult • Maternal and Child Health (MCH)

4. Background (cont.) • Health Outcomes • Smoking Attributable Mortality (SAM) • Smoking Attributable Years of Potential Life Lost (YPLLs) • Economic Outcomes • Smoking Attributable Healthcare Expenditures • Smoking Attributable Productivity Losses (adult only)

5. Policy Relevance • For each state and the entire U.S. SAMMEC quantifies smoking attributable • Deaths • Expenditures • This information assists decision makers in enacting legislation and allocating resources to reduce the burden of smoking related diseases (SRDs)

6. Methods • Smoking Attributable Mortality • Smoking Status • Smoking Prevalence • Relative Risks • No. of deaths per Smoking Related Disease (SRD) • Smoking Attributable Fraction (SAF) Formula

7. Methods (cont.) • SAM = D x SAF where D = No. of deaths per Smoking Related Disease (SRD) SAF = Smoking Attributable Fraction per SRD

8. Methods (cont.) • Smoking Attributable Years of Potential Life Lost YPLL = SAM*RLE where SAM = Smoking Attributable Mortality RLE = Remaining Life Expectancy

9. Methods (cont.) • Smoking Attributable Productivity Losses SAPL = SAM*PVFE where SAM = Smoking Attributable Mortality PVFE = Present Value of Future Earnings

10. Updates • The list of Adult SAMMEC diseases have been modified based on the recommendations of the 2004 Surgeon General’s Report on the Health Consequences of Tobacco (The Health Consequences of Smoking: A Report of the Surgeon General, 2004).

11. Updates (cont.) SMOKING ATTRIBUTABLE DISEASES and ICD-10 CODES MALIGNANT NEOPLASMS LIP,ORALCAVITY,PHARYNX C00-C14 ESOPHAGUS C15 STOMACH C16 PANCREAS C25 LARYNX C32 TRACHEA / LUNG / BRONCHUS C33-C34 CERVIX UTERI C53 KIDNEY & RENAL PELVIS C64-C65 BLADDER C67 ACUTE MYELOID LEUKEMIA C92.0 CARDIOVASCULAR DISEASES ISCHEMIC HEART DISEASE I20-I25 RHEUMATIC HEART DISEASE I00-I09 PULMONARY HEART DISEASE I26-I28 OTHER HEART DISEASE I29-I51 CEREBROVASCULAR DISEASE I60-I69 ATHEROSCLEROSIS I70 AORTIC ANEURYSM I71 OTHER CIRCULATORY DISEASES I72-I78 RESPIRATORY DISEASES INFLUENZA J10-J11 PNEUMONIA J12-J18 BRONCHITIS J40-J42 EMPHYSEMA J43 CHRONIC AIRWAYS OBST. J44

12. Updates (cont.) • Updated the following data elements for 2001: • National and state level smoking prevalence • Remaining life expectancy • PVFE • Added the following data elements: • Resident Population data • Standard Population data • Adult SAMMEC now calculates and reports age-adjusted SAM and YPLL rates per 100,000 population

13. Updates (cont.) • Adult SAMMEC now reports the following average estimates for the period 1997–2001: • SAM • YPLL • Productivity Losses • SAM rates • YPLL rates • Adult SAMMEC allows users to change all input data simultaneously by selecting the study population at the bottom of the Data Elements box

14. Data and Internet Address • National and state-level data and algorithms are preloaded in the SAMMEC software program • SAMMEC is available at http://apps.nccd.cdc.gov/sammec/intro.asp

15. SAMMEC Future Direction • Adult updates scheduled for 2006 • SAHE for 2003 • SAM, YPLL, Productivity Losses, SAM rate, YPLL rate for 2002 and 2003 • Five Year reports for 1998-2002 and 1999-2003 • Annual updates thereinafter