Using Agent-Based Models to Address “Wicked Problems” Like Tobacco Use: A Report From the Institute of Medicine
Authors: Nancy A. Rigotti, Robert B. Wallace
Journal: Annals of Internal Medicine (2015)

Ideas and Opinions15 September 2015Using Agent-Based Models to Address “Wicked Problems” Like Tobacco Use: A Report From the Institute of MedicineNancy A. Rigotti, MD and Robert B. Wallace, MD, MScNancy A. Rigotti, MDFrom Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, and The University of Iowa, Iowa City, Iowa.Search for more papers by this author and Robert B. Wallace, MD, MScFrom Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, and The University of Iowa, Iowa City, Iowa.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1567 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Tobacco use is a stubborn problem. It remains the leading cause of preventable death and disease in the United States despite more than 6 decades of clinical, public health, and public policy efforts (1). Tobacco use is recalcitrant because nicotine is highly addictive; powerful behavioral, social, and cultural factors sustain it; and the goals of stakeholders (such as public health officials, tobacco manufacturers, retailers, and the tobacco control community) conflict. These factors have earned tobacco the dubious distinction of being called a “wicked problem,” which refers to complex social problems with large economic burdens that resist simple solutions and bedevil ...References1. U.S. Department of Health and Human Services. The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. Google Scholar2. Kolko J. Wicked Problems: Problems Worth Solving: A Handbook and a Call to Action. Austin: Austin Center for Design; 2012. Google Scholar3. U.S. Department of Health and Human Services. Appendix 15.1: tobacco control simulation models. In: The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. Google Scholar4. Institute of Medicine. Assessing the Use of Agent-Based Models for Tobacco Regulation. Washington, DC: National Academies Pr; 2015. Google Scholar5. Hammond RA. Complex systems modeling for obesity research. Prev Chronic Dis. 2009;6:A97. [PMID: 19527598] MedlineGoogle Scholar6. Nianogo RA, Arah OA. Agent-based modeling of noncommunicable diseases: a systematic review. Am J Public Health. 2015;105:e20-31. [PMID: 25602871] doi:10.2105/AJPH.2014.302426 CrossrefMedlineGoogle Scholar7. Marshall BD, Galea S. Formalizing the role of agent-based modeling in causal inference and epidemiology. Am J Epidemiol. 2015;181:92-9. [PMID: 25480821] doi:10.1093/aje/kwu274 CrossrefMedlineGoogle Scholar8. Lee KA, Dziadkowiec O, Meek P. A systems science approach to fatigue management in research and health care. Nurs Outlook. 2014;62:313-21. [PMID: 25218080] doi:10.1016/j.outlook.2014.07.002 CrossrefMedlineGoogle Scholar9. Chakrabarti A, Verbridge S, Stroock AD, Fischbach C, Varner JD. Multiscale models of breast cancer progression. Ann Biomed Eng. 2012;40:2488-500. [PMID: 23008097] doi:10.1007/s10439-012-0655-8 CrossrefMedlineGoogle Scholar10. Rubin MA, Jones M, Leecaster M, Khader K, Ray W, Huttner A, et al. A simulation-based assessment of strategies to control Clostridium difficile transmission and infection. PLoS One. 2013;8:e80671. [PMID: 24278304] doi:10.1371/journal.pone.0080671 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Nancy A. Rigotti, MD; Robert B. Wallace, MD, MScAffiliations: From Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, and The University of Iowa, Iowa City, Iowa.Acknowledgment: The authors thank Amy Geller of the Institute of Medicine for her contributions to the development of this manuscript and as Study Director for the Institute of Medicine report. The members of the Committee on the Assessment of Agent-Based Models to Inform Tobacco Product Regulation were Robert Wallace (chair), Elizabeth Bruch, Karen Glanz, Carlos Roberto Jaén, Scott Leischow, Douglas Luke, Charles Manski, David Mendez, Nancy Rigotti, David Shoham, Jody Sindelar, and Melissa Stigler.Grant Support: The authors received no funding for their participation in the Institute of Medicine report, which was funded by the U.S. Food and Drug Administration, or for preparing this manuscript.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1567.Corresponding Author: Nancy A. Rigotti, MD, Division of General Internal Medicine, Massachusetts General Hospital, 50 Staniford Street, Room 914, Boston, MA 02114; e-mail, nrigotti@partners.org.Current Author Addresses: Dr. Rigotti: Division of General Internal Medicine, Massachusetts General Hospital, 50 Staniford Street, Room 914, Boston, MA 02114.Dr. Wallace: The University of Iowa College of Public Health, Department of Epidemiology, 145 Riverside Drive, Iowa City, IA 52242.Author Contributions: Conception and design: N.A. Rigotti, R.B. Wallace.Drafting of the article: N.A. Rigotti, R.B. Wallace.Critical revision of the article for important intellectual content: N.A. Rigotti, R.B. Wallace.Final approval of the article: N.A. Rigotti, R.B. Wallace.Administrative, technical, or logistic support: R.B. Wallace.This article was published online first at www.annals.org on 28 July 2015. 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