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Oxford's research has helped reduce smoking prevalence and tobacco-related mortality worldwide. Our epidemiological studies have documented the varied ways in which smoking causes death in many countries, as well as the large benefits of smoking cessation, and have strongly influenced the WHO/Bloomberg 2008 MPOWER package, the key document guiding governmental tobacco policy worldwide. Oxford University researchers have also coordinated the systematic reviews that underpin effective evidence-based policies for encouraging smoking cessation both in the UK and worldwide, for example providing evidence supporting NICE guidance for smoking cessation.
Systematic quantitative reviews of epidemiological evidence linking parental smoking with adverse respiratory health effects in childhood were published in 1997-1999 in Thorax. These meta-analyses were updated as a contribution to the US Surgeon-General's report on Secondhand Smoking, published in 2006, and the UK Royal College of Physicians' report on Passive Smoking and Children, published in 2010.
Over this period the adverse health effects of environmental tobacco smoke achieved prominence in public health policy, through campaigns for smoke-free workplaces (including pubs and restaurants) and publicity against parental smoking in the presence of children, both in cars and in the home.
Research by the Institute for Social Marketing (ISM) contributed directly to the development of the 2009 Health Act (England and Wales) and the Tobacco & Primary Medical Services (Scotland) Act 2010, the latter the most significant change in Scottish tobacco control legislation since the 2005 ban on public smoking. Both acts restrict the display of tobacco at the point of sale (PoS) in order to make tobacco products less attractive and accessible. Instrumental in the passage of both Acts was ISM research showing how PoS influences consumer behaviour and that it has a clear effect on adult and youth smoking.
UCL research on statistical methodology has underpinned important investigations by scientists at Oxford University into the relationship between exposure to the naturally occurring radioactive gas radon and lung cancer. The resulting dose-response relationships and risk estimates have informed advice given in 2008-10 to the UK government by the Health Protection Agency about the risk of radon exposure and the cost-effectiveness of radon control policies. They have also influenced the conclusions of the World Health Organization about indoor radon and lung cancer, as reported in their 2009 handbook. Furthermore, the research findings have led to proposals for changes to building regulations in the UK and elsewhere, and changes to the building code in Finland have resulted in a reduction in the average indoor radon concentration in new homes.
Research into point of sale tobacco marketing (POS) by the Institute for Social Marketing (ISM), based in Stirling Management School contributed directly to the passage of the 2009 Health Act (England and Wales) and the Tobacco & Primary Medical Services (Scotland) Act 2010, and was instrumental in defending this and equivalent legislation in Norway and Ireland from legal challenge. The UK acts build on ISM research showing that in-shop displays influence consumer behaviour and independently encourage the onset of youth smoking; they require tobacco products to be out of sight at PoS.
Smoke-free laws are public policies that prohibit tobacco smoking in workplaces and other public spaces. Since the end of March 2006, smoking has been prohibited by law in all enclosed public spaces throughout Scotland, with the specific aim of protecting non-smokers from the effects of second-hand smoke. Studies led by the University of Glasgow have provided the most robust available evidence that smoke-free laws have a significant impact on rates of heart disease, childhood asthma, complications in pregnancy, and stroke. This evidence has been used to support policy debate and decision making in Scotland, the rest of the UK, and around the world, providing guidance for other countries to implement similar legislation. This research has also provided a focal point for an extended and high profile global public debate over smoking legislation, and underpins health advice and campaigns published by the World Health Organization (WHO), World Heart Federation and other international bodies.
Studies coordinated by the University of Oxford's Clinical Trial Service Unit (CTSU) within the Nuffield Department of Population Health (NDPH) have strongly influenced the labelling of statin medication internationally, treatment guidelines, and the resulting changes in prescribing have contributed to reductions in mortality and morbidity from heart attack and ischaemic stroke in many countries. CTSU's randomised trials and meta-analyses of trials have shown that lowering low-density lipoprotein (LDL) cholesterol safely reduces the risk of heart attacks, strokes and revascularisation procedures in a wide range of people, and work conducted in collaboration with the NDPH's Health Economic Research Centre has provided clear evidence of cost-effectiveness of statins.
There is no `magic bullet' for helping intractable smokers to quit. Rather, the story of this research is one of multiple studies that have built the knowledge base incrementally, allowing Professor of Clinical Psychology Peter Hajek and his team at the Wolfson Institute of Preventative Medicine to produce a targeted, evidence-based model of a specialist treatment that has fed directly into the establishment of the NHS smoking cessation service (NHS-SSS) and national smoking cessation policy (including NICE guidance), and changed clinical practice. The NHS-SSS treats 800,000 smokers per year. The approach is influential globally and has now been used in treating several million smokers and preventing hundreds of thousands of premature deaths.
Research, policy development, evaluation and advocacy work at The University of Nottingham has achieved significant impact in helping to prevent the harm to health caused by smoking, which is the largest avoidable cause of death and disability, and of social inequalities in health, in the UK. This impact has been achieved through contributions in two areas of prevention: (1) conventional population- and individual-level interventions to prevent smoking uptake and promote smoking cessation; and (2) novel population-level measures to encourage substitution of smoked tobacco with alternative, low hazard nicotine products as a harm reduction strategy.
QRISK is a new algorithm which predicts an individual's risk of cardiovascular over 10 years. It was developed using the QResearch database and is in routine use across the NHS. It is included in national guidelines from NICE and the Department of Health and in the GP quality and outcomes framework. It is incorporated into > 90% of GP computer systems as well as pharmacy and secondary care systems. The web calculator has been used >500,000 times worldwide. ClinRisk Ltd was incorporated in 2008 to develop software to ensure the reliable widespread implementation of the QRISK algorithm into clinical practice.