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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.
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.
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.
ASSIST (A Stop Smoking in School Trial) is reducing smoking rates among teenagers by 22%. `DECIPHer' Impact Ltd was set up to rollout the ASSIST programme which has been adopted widely in England and Wales with 26 licences being commissioned. The company has achieved £240K annual turnover. As a result, an estimated 1674 young people have not taken up smoking. The Lancet estimates that if ASSIST were implemented across the UK, 40,000 teenagers a year would not start smoking.
ASSIST has been commended by the English and Welsh Governments and recommended in National Institute for Health and Care Excellence (NICE) guidelines.
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.
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.
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.
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.
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.