# OLM 0.2 model file. Specification: spec/OLM-SPEC.md olm: "0.2" id: us-lifestyle name: "US adults: smoking, weight and exercise" version: 0.1.0 status: experimental license: CC-BY-4.0 authors: - name: OpenLifeModel contributors url: https://github.com/OpenLifeModel/openlifemodel description: >- Adjusts US population mortality for three of the best-measured lifestyle factors: cigarette smoking (including the age you quit), body mass index and leisure-time exercise. Each effect comes from a large published study of all-cause mortality; the share of US adults in each group comes from NHANES. population: >- US adults aged roughly 25 to 80, without serious chronic disease. The source studies followed people in this range; effects at older ages are extrapolated. assumptions: - >- Baseline mortality is the SSA 2023 period life table: today's death rates, with no future improvement. - >- Each factor's hazard ratio is constant over the rest of life. In reality the excess risk from high BMI shrinks with age (Global BMI Mortality Collaboration 2016), so effects at old age are probably overstated. - >- Factors multiply. The exercise effect is adjusted for smoking and BMI and the smoking effect for adiposity, which limits double-counting; the BMI effect is not adjusted for exercise, so part of it may overlap. - >- Hazard ratios are rescaled so that a person with the average US adult mix of each factor reproduces the baseline. The mix is for all adults aged 20 and over, not specific to your age and sex. - >- Smoking risk for people who quit is taken from the age at which they quit; people who quit within the previous 5 years were counted as current smokers in the source study. - Exercise means leisure-time activity only, not work or commuting. sources: - id: ssa-2023 citation: >- Social Security Administration, Office of the Chief Actuary. Actuarial Life Table: Period Life Table, 2023, as used in the 2026 Trustees Report. url: https://www.ssa.gov/oact/STATS/table4c6.html license: Public domain (US federal government work) notes: Death probabilities transcribed from the published table on 4 October 2026. - id: jha-2013 citation: >- Jha P, Ramasundarahettige C, Landsman V, et al. 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med. 2013;368(4):341-350. doi: 10.1056/NEJMsa1211128 notes: >- NHIS 1997-2004 linked to deaths through 2006; ages 25-79. Hazard ratios from Figure 4 (sexes combined), adjusted for age, education, alcohol and adiposity. - id: gbmc-2016 citation: >- The Global BMI Mortality Collaboration. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388(10046):776-786. doi: 10.1016/S0140-6736(16)30175-1 notes: >- Primary analysis (never-smokers without chronic disease, first 5 years of follow-up excluded), WHO categories relative to 18.5-25, adjusted for age and sex (Table 1). - id: arem-2015 citation: >- Arem H, Moore SC, Patel A, et al. Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern Med. 2015;175(6):959-967. doi: 10.1001/jamainternmed.2015.0533 notes: >- Six US and European cohorts, 661,137 adults. Hazard ratios by MET-hours per week (1 MET-hour = 20 moderate-equivalent minutes), adjusted for age, sex, race, education, smoking, alcohol, marital status, cancer and heart disease history, and BMI. - id: nhanes-2017-2020 citation: >- National Center for Health Statistics. National Health and Nutrition Examination Survey, 2017-March 2020 prepandemic files (P_DEMO, P_BMX, P_SMQ, P_PAQ). Survey-weighted shares of adults aged 20 and over. url: https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/default.aspx?Cycle=2017-2020 license: Public domain (US federal government work) notes: Computed by models/derivations/nhanes_prevalence.py in this repository. baseline: type: period-life-table source: ssa-2023 start_age: 0 qx: male: [ 0.006015, 0.000479, 0.000320, 0.000249, 0.000194, 0.000159, 0.000137, 0.000125, 0.000120, 0.000120, 0.000125, 0.000140, 0.000173, 0.000233, 0.000327, 0.000463, 0.000634, 0.000819, 0.000999, 0.001138, 0.001235, 0.001315, 0.001378, 0.001439, 0.001509, 0.001595, 0.001685, 0.001783, 0.001876, 0.001970, 0.002085, 0.002202, 0.002308, 0.002407, 0.002490, 0.002577, 0.002665, 0.002764, 0.002864, 0.002987, 0.003115, 0.003253, 0.003419, 0.003600, 0.003777, 0.003931, 0.004073, 0.004245, 0.004477, 0.004795, 0.005126, 0.005496, 0.005917, 0.006404, 0.006923, 0.007491, 0.008173, 0.008938, 0.009714, 0.010494, 0.011337, 0.012232, 0.013196, 0.014229, 0.015316, 0.016455, 0.017574, 0.018735, 0.019981, 0.021366, 0.022903, 0.024615, 0.026504, 0.028648, 0.031071, 0.033802, 0.037010, 0.041158, 0.045461, 0.050346, 0.055633, 0.061757, 0.068358, 0.075420, 0.083364, 0.092680, 0.103459, 0.115502, 0.129018, 0.143810, 0.159458, 0.176551, 0.195360, 0.216286, 0.238799, 0.262268, 0.286291, 0.310944, 0.332325, 0.349036, 0.366568, 0.384960, 0.404252, 0.424488, 0.445712, 0.467998, 0.491398, 0.515968, 0.541766, 0.568854, 0.597297, 0.627162, 0.658520, 0.691446, 0.726018, 0.762319, 0.800435, 0.840457, 0.882480, 0.926604 ] female: [ 0.005125, 0.000392, 0.000229, 0.000188, 0.000155, 0.000133, 0.000115, 0.000105, 0.000100, 0.000098, 0.000101, 0.000111, 0.000126, 0.000152, 0.000188, 0.000229, 0.000273, 0.000323, 0.000372, 0.000410, 0.000441, 0.000476, 0.000513, 0.000546, 0.000582, 0.000609, 0.000641, 0.000683, 0.000740, 0.000808, 0.000878, 0.000947, 0.001018, 0.001089, 0.001154, 0.001209, 0.001263, 0.001347, 0.001438, 0.001533, 0.001643, 0.001742, 0.001845, 0.001954, 0.002075, 0.002187, 0.002306, 0.002438, 0.002595, 0.002791, 0.003030, 0.003288, 0.003554, 0.003847, 0.004172, 0.004532, 0.004923, 0.005365, 0.005815, 0.006333, 0.006923, 0.007555, 0.008220, 0.008881, 0.009514, 0.010188, 0.010880, 0.011659, 0.012543, 0.013581, 0.014769, 0.016153, 0.017705, 0.019495, 0.021533, 0.023846, 0.026458, 0.029700, 0.033135, 0.036982, 0.041183, 0.045959, 0.051282, 0.057262, 0.064107, 0.071752, 0.080490, 0.090566, 0.102204, 0.115178, 0.129176, 0.144229, 0.160353, 0.177635, 0.196502, 0.216846, 0.238750, 0.261359, 0.283899, 0.306491, 0.329680, 0.353333, 0.377300, 0.401416, 0.425501, 0.451031, 0.478092, 0.506778, 0.537185, 0.568854, 0.597297, 0.627162, 0.658520, 0.691446, 0.726018, 0.762319, 0.800435, 0.840457, 0.882480, 0.926604 ] adjustment: method: proportional-hazards normalization: population-average factors: - id: smoking label: Smoking input: smoking_status type: categorical missing: neutral source: jha-2013 notes: >- Shares of the population from NHANES 2017-2020. The "former, quit age unknown" ratio (1.2) is the population-weighted average of the quit-age groups. levels: - {value: never, hazard_ratio: 1.0, prevalence: 0.582} - {value: former_quit_before_35, hazard_ratio: 1.0, prevalence: 0.129} - {value: former_quit_35_44, hazard_ratio: 1.2, prevalence: 0.053} - {value: former_quit_45_54, hazard_ratio: 1.5, prevalence: 0.039} - {value: former_quit_55_plus, hazard_ratio: 1.7, prevalence: 0.029} - {value: former, hazard_ratio: 1.2, prevalence: 0.0} - {value: current, hazard_ratio: 2.9, prevalence: 0.169} - id: bmi label: Body mass index input: bmi type: banded missing: neutral source: gbmc-2016 notes: Shares of the population from NHANES 2017-2020 measured BMI. bands: - {max: 18.5, hazard_ratio: 1.47, prevalence: 0.014} - {min: 18.5, max: 25, hazard_ratio: 1.0, prevalence: 0.249} - {min: 25, max: 30, hazard_ratio: 1.11, prevalence: 0.317} - {min: 30, max: 35, hazard_ratio: 1.44, prevalence: 0.219} - {min: 35, max: 40, hazard_ratio: 1.92, prevalence: 0.111} - {min: 40, hazard_ratio: 2.71, prevalence: 0.09} - id: activity label: Exercise input: mvpa_minutes_per_week type: banded missing: neutral source: arem-2015 notes: >- Bands are the study's MET-hour categories converted to moderate-equivalent minutes (0, under 7.5, 7.5-15, 15-22.5, 22.5-40, 40-75 and 75+ MET-hours). Shares from NHANES 2017-2020. bands: - {max: 1, hazard_ratio: 1.0, prevalence: 0.457} - {min: 1, max: 150, hazard_ratio: 0.8, prevalence: 0.154} - {min: 150, max: 300, hazard_ratio: 0.69, prevalence: 0.118} - {min: 300, max: 450, hazard_ratio: 0.63, prevalence: 0.086} - {min: 450, max: 800, hazard_ratio: 0.61, prevalence: 0.11} - {min: 800, max: 1500, hazard_ratio: 0.61, prevalence: 0.055} - {min: 1500, hazard_ratio: 0.68, prevalence: 0.019} tests: # Values produced by the reference engine (OLM 0.1 method). - name: Nothing provided reproduces the SSA baseline profile: {age: 40, sex: male} expect: remaining_life_expectancy: {value: 38.5795, tolerance: 0.001} equivalent_age: {value: 40, tolerance: 0.0001} combined_hazard_ratio: {value: 1, tolerance: 0.000001} - name: Never smoked, BMI 23, 200 minutes of exercise, male aged 40 profile: {age: 40, sex: male, smoking_status: never, bmi: 23, mvpa_minutes_per_week: 200} expect: remaining_life_expectancy: {value: 47.2914, tolerance: 0.001} equivalent_age: {value: 30.2253, tolerance: 0.001} median_age_at_death: {value: 89.9394, tolerance: 0.001} combined_hazard_ratio: {value: 0.4349, tolerance: 0.0001} - name: Current smoker, BMI 36, no exercise, male aged 40 profile: {age: 40, sex: male, smoking_status: current, bmi: 36, mvpa_minutes_per_week: 0} expect: remaining_life_expectancy: {value: 25.3023, tolerance: 0.001} equivalent_age: {value: 55.518, tolerance: 0.001} survival_to_80: {value: 0.1122, tolerance: 0.0001} combined_hazard_ratio: {value: 3.5094, tolerance: 0.0001} - name: Quit smoking at 45-54, BMI 27, 300 minutes, female aged 60 profile: {age: 60, sex: female, smoking_status: former_quit_45_54, bmi: 27, mvpa_minutes_per_week: 300} expect: remaining_life_expectancy: {value: 28.1445, tolerance: 0.001} equivalent_age: {value: 55.9844, tolerance: 0.001} survival_to_90: {value: 0.4852, tolerance: 0.0001} survival_to_100: {value: 0.0991, tolerance: 0.0001}