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Ground-breaking experimental research at the University of Bristol assessing the effectiveness of standardised tobacco packaging legislation has been strongly influencing international tobacco policy and legislation since 2011. Work by scientists in the School of Experimental Psychology was the first to show, using direct, objective measures, that standardised tobacco packaging modifies relevant behaviours. Australia became the first country in the world to implement standardised packaging legislation in 2012 after reviewing the University of Bristol research in their High Court in response to legal challenges from the tobacco industry. That same year, the European Commission's update of the Tobacco Products Directive cited the same University of Bristol research to support the claim that standardised packaging would strengthen the effectiveness of graphic health warnings on tobacco products. The UK government has also used the University of Bristol research to inform the consultation on standardised packaging of tobacco products.
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.
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 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.
Smoking is the single most important preventable cause of mortality and inequalities in health in the UK. Tobacco use causes over 100,000 deaths each year in the UK, with around 10,000 of these due to non-smokers' exposure to secondhand smoke. The total cost of smoking to society is estimated to be over £13 billion. The UoE Tobacco Control Research Group's (TCRG) research and knowledge exchange activities have significantly influenced tobacco control policy and practice in the UK (http://www.cphs.mvm.ed.ac.uk/groups/tcrg or http://tinyurl.com/nwxcpnh). More specifically, their research on smoking and non-smoking by young people has influenced smoking prevention and cessation policy at the national level in Scotland and England and at regional/local levels. Their evaluation studies of the national smoke-free legislation in Scotland and England provided important evidence on the legislation's positive public health impact, thereby undermining the case for repealing or diluting the legislation. Their research on reducing smoking in the home has influenced national policy and practice on this issue in Scotland including national mass media campaigns.
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.
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.
University of Aberdeen research had impact on public policy as it was instrumental in the introduction of legislation in Scotland to restrict smoking in public places. The implementation of the legislation has impacted on the health of the public and benefited the economy through reduced use of health services.
Exposure to environmental tobacco smoke (ETS) — passive smoking — had been estimated to cause more than 1,000 deaths per year in Scotland and significant morbidity. International evidence was used to model the health and economic impacts of potential legislation to eliminate smoking in public places in Scotland, under a range of scenarios. The net present value of all the benefits and costs over 30 years was demonstrated to be positive under all the scenarios examined, with a central estimate of +£4.6 billion (ranging from +£0.056 billion to +£7.4 billion).
The research results provided convincing evidence to support the passage of legislation. Following the implementation of smokefree public places in Scotland, evidence of the resulting health benefits have been accruing from 2008. These include significant reductions in admissions for acute coronary syndrome and for childhood asthma, reductions in complications of pregnancy (pre-term delivery and small for gestational age) and improvements in bar workers' health.
The claimed impact, as defined by REF guidance, therefore includes: public health and welfare have improved; public behaviour and the control of disease has changed.
We have achieved significant and far reaching impact in the field of public health outcomes, policy and practice. For the first time, age/sex disaggregated estimates of smoking and ex-smoking prevalence were made available for approximately 7700 electoral wards in England and around 1000 postcode sectors for Scotland. The information has influenced national tobacco control policies (e.g. the ban of smoking in enclosed public spaces in England) and has impacted on national smoking-related health inequalities by targeting delivery of cessation services where they are most needed. Findings have also informed anti-smoking campaigns led by health authorities, charities and pressure groups.