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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.
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 by the School of Pharmacy has been used by the UK Government in their drive to improve the nation's public health. Our evidence base was used to inform the 2008 White Paper "Pharmacy in England: Building on Strengths — Delivering the Future". Healthy Living Pharmacies, recommended by the White Paper, have been piloted leading to improved engagement with local commissioners, further training for pharmacy staff, more cost-effective delivery of public health services, and an increase in public awareness and access to these services. In addition, the Government backed Pharmacy and Public Health Forum is utilising our research in its remit to develop, implement and evaluate public health practice in pharmacy.
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.
The txt2stop trial, led by LSHTM, provided robust evidence that smoking cessation support delivered by text messaging doubles biochemically verified quitting at six months and is highly cost-effective. The research resulted in a new smoking cessation service delivered by text message in England, with over 34,000 smokers having joined the programme by the end of March 2013. The research was noted in international forums and used by WHO in a presentation to member countries; at least four countries have taken steps to roll out their own programmes. The trial findings received exceptionally wide media coverage in 2011.
Research carried out at Cardiff University refined an addiction counselling method, motivational interviewing, co-founded previously by Rollnick, to improve the consultation for changing health behaviour (e.g. diet, exercise, smoking and drinking). Their published findings and resulting method are now used in health care worldwide, with good evidence for effectiveness. The impact of this work has been described as `immeasurable' and is reflected in industry guidelines and policy documents, and diverse clinical efforts that include the treatment of children with HIV-AIDS in Africa.
Since 2010, over 60,000 Year 8 students (including over 11,000 trained peer supporters) have been exposed to a new smoking prevention programme which has achieved a projected 1674 fewer teenage smokers. DECIPHer-ASSIST, a theoretically-grounded peer-led, schools-based smoking prevention intervention was developed and evaluated during research studies conducted at Cardiff University. An MRC-funded trial demonstrated that this intervention reduced the prevalence of smoking by 10% and that it is cost-effective. The intervention has been highlighted in numerous national strategy documents and was recommended in NICE guidance. It is being implemented under licence by public health providers in 23 areas across the UK. A new Cardiff University-owned company (DECIPHer Impact Ltd) sells these licences and supports the delivery of ASSIST in secondary schools.
Research and development at the University of Surrey of a guided audio to help abstinent smokers manage their stress, smoking cravings and tobacco withdrawal symptoms.
The audio — in MP3 format — is freely available on the NHS Stop Smoking website, and is part of the NHS smoking `Quit Kit'. The audio has been downloaded 81,396 times (as of May, 2013). The main user groups of the audio are NHS patients wishing to stop smoking, and members of the general population.
The further development of the UK Physical Activity guidelines in 2010 highlighted the need to consider the emerging research in the area of sedentary behaviour. Prof S. Biddle at Loughborough University, based upon his and the Unit's leading research in this area, was invited to Chair a working group to review and make recommendations regarding the incorporation of guidance on sedentary behaviour into these new national policies. This group, drawing on the original work of Biddle and co-workers, set out clear recommendations for the incorporation of sedentary behaviour into the UK national Physical Activity Guidelines through the `Sedentary Behaviour and Obesity: Review of the Current Scientific Evidence' report (2010).
Physical Activity guidelines in the UK had never included recommendations for sedentary behaviour, until the publication of `Start Active, Stay Active' (2011), as a direct result of the Unit's research.