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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.
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.
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.
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 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.
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.
Research carried out by Professor Susan Michie and colleagues led to the establishment of the NHS Centre for Smoking Cessation and Training (NCSCT) in 2009 to improve the quality of national stop smoking service provision. The team won the Department of Health contract to form the NCSCT which has led to important quality improvements as demonstrated by increases in knowledge and skills of practitioners, and improvements in success rates. It is estimated that to date the NCSCT has been responsible for an additional 7,500 smokers stopping long-term, saving an estimated 6,500 life years at an incremental cost of less than £500 per life year gained.
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.