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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.
UEL's Drugs and Addictive Behaviours Research Group (DABRG) was the first UK group to demonstrate that regular smoking can cause stress and depression. This work has had - and continues to have - a significant impact on public awareness and understanding of the effects of smoking on mood and cognition. Input into the Department of Health Consultation on the Future of Tobacco Control has directly fed into UK Tobacco Control Policy. More recent research on electronic cigarettes has informed public health professionals, smokers and users about the nature and effects of e-cigarette use. In particular, the work has underpinned the development and delivery of new and improved evidence-based information resources for use by these stakeholders. It has also delivered commercial benefits for e-cigarette manufacturers, whose marketing strategies, lobbying activities and preparations for regulatory control have been directly informed by this work.
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.
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.
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.
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.
Professor Adrian Taylor and colleagues in Exeter Sport and Health Sciences (SHS) have conducted: (1) laboratory studies to identify the dose of exercise that is sufficient to acutely impact on affect, mood and smoking-related outcomes; (2) rigorous randomised controlled trials to evaluate chronic interventions to increase physical activity among depressed patients, and smokers wishing to reduce or quit; and (3) rigorous systematic reviews and meta-analyses to inform guidance for health care practitioners and policy makers. This work has significantly contributed to the evidence-base underpinning global health care policy guidelines (including those produced by the National Institute for Health and Care Excellence (NICE)), as well as raising global media interest, informing public debate and clinically supporting patients and practitioners on best practice. Commissioned reviews have also identified gaps in the evidence-base for the effects of physical activity on mental health and nicotine addiction which has led to the prioritisation of funding for further research to resolve uncertainty in clinical guidelines.
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.