UK smoking rates showed a record annual fall between 2015 and 2016 of 1.5 percentage points, based on new statistics released today [Link]. The prevalence of smoking among people aged 18 and above in 2016 was 15.8%, the lowest on record. This dramatic reduction is also the second largest annual fall in the last 40 years.
The UK is an international leader in smoking prevention policy, having introduced high tobacco taxes, a comprehensive advertising ban, prohibited smoking in public places, taken tobacco products out of sight in shops, establishing specialist stop-smoking services and a range of other measures. These policies have caused a sustained downward trend in adult smoking prevalence over the past two decades. Over the past five years, however, the rate of decline has increased substantially, falling by 4.4 percentage points, from 20.2%, since 2011.
Today’s new figures indicate UK smoking is falling faster than would be expected from conventional tobacco control approaches. While all the policies put in place will have made a difference, the most likely explanation for the recent rapid decline is the increasing use by smokers of electronic cigarettes as a substitute for tobacco. Data released by ASH last month estimated that there are now 1.5m people in the UK who used to smoke but now instead use electronic cigarettes.
Professor John Britton said:
“Electronic cigarettes were patented in 2004 but we began to see their use in the UK from around 2010. Since then the proportion of smokers using them has risen steadily. They have rapidly become the most popular aid to stopping smoking, and are now used in more than one third of quit attempts. At first we were unsure what their impact on smoking rates would be, but today’s figures suggest that alongside established tobacco control policies, they may have significantly accelerated the downward trend in smoking”
“Overall these findings vindicate UK policy on vaping: and that doing more to encourage more smokers to make the switch could generate huge benefits in public health: especially among those groups in society where smoking remains common.”
Professor Ann McNeill said:
“Since the millennium the UK has implemented a comprehensive tobacco control strategy to encourage and support smokers to stop and to deter young people from taking up smoking. This strategy included encouraging smokers to switch from deadly cigarettes to less harmful forms of nicotine including electronic cigarettes. It is really important that the new government continues this comprehensive approach and publishes its new Tobacco Control Plan as soon as possible, particularly given the need to tackle inequalities in smoking rates across society. In times of austerity, tobacco control is a good investment, as it benefits not just smokers and their families, but services like the NHS which bear the enormous costs of treating smoking-related illnesses”
Professor Linda Bauld added:
“The UK has taken a liberal approach to vaping, supporting the use of these consumer products for smokers who choose to use them. This has been controversial, and other countries have taken a much more restrictive approach. These new prevalence figures for adults, alongside steady declines in youth smoking uptake, suggest that electronic cigarettes may turn out to be a game changer for tobacco control. However, we know that many smokers are still wary of these products and think they are as harmful as tobacco. That needs to change if the positive trend we see from today’s figures is to be maintained.”
• Adult smoking habits in the UK: 2016 – Released 15 June 2017 External Link
• Smoking statistics in England – 15 June 2017 – Latest smoking compendium report signposting to all the up-to-date smoking data. External Link
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The Cochrane Tobacco Addiction Group (TAG) conducts and facilitates systematic reviews and meta-analyses of the research evidence for tobacco cessation and prevention interventions. The group was founded in 1996 and in 2016 they conducted a stakeholder engagement project to celebrate the 20th anniversary of TAG and to identify future research priorities for the group and the wider tobacco control community.
The objective of the project was to:
- Raise awareness of Cochrane TAG and what has been achieved so far.
- Identify areas where further research is needed in the areas of tobacco control and smoking cessation.
- Identify specific goals for Cochrane TAG
- To explore novel ways to disseminate the findings of tobacco research, and Cochrane TAG’s findings.
The survey and workshop resulted in 183 unanswered research questions in the areas of tobacco, quitting smoking and eight priority research areas, including:
- ‘addressing inequalities’
- ‘treatment delivery’
- electronic cigarettes’
- ‘initiating quit attempts’
- ‘young people’
- ‘mental health and substance abuse’
- ‘population-level interventions’
Stakeholders who attended the workshop also discussed ways that the public health community and Cochrane TAG could act to move the field of tobacco control forward.
Through this report, Cochrane TAG want to share the identified unanswered questions with the wider tobacco research community to help them to decide the most important research to focus on in the future, and to decide the most important things to work on for Cochrane TAG.
This will involve updating existing reviews, beginning reviews on new topics, and looking in more detail at Cochrane TAG’s research methods.
Contrary to popular belief there are still many important unanswered questions in the field of tobacco control. In addition, it has been noted that many of the results of tobacco control questions are not always reaching their intended targets. Tobacco control stakeholders provide a rich source of information on how these uncertainties should be prioritised; by using this resource the likelihood that the findings of research are useful and will be implemented is much greater. The project was carried out with the hope that researchers and research funders will be able to use the priorities identified to inform their future practice, in the same way that Cochrane TAG are using them to inform new review topics, updates of reviews and methods development.
Cochrane TAG’s findings and implementation suggestions should be considered alongside the existing evidence base and clinical expertise.
You can open the report and the appendices by clicking on the covers below:
Discussing the future of tobacco addiction research with the Cochrane Tobacco Addiction Group:
The CTAG taps project ran from January-December 2016. Activities carried out from April 2016-December 2016 were funded by the NIHR School for Primary Care Research (SPCR)
GRAND is a Pfizer-supported independently reviewed competitive grants program awarding individual grants of up to $200,000 from a total fund in 2017 of $1 million to support projects which directly advance the use of pharmacotherapy for treating users of any nicotine or tobacco product in clinical practice. Of 486 applications received since 2008, 62 grants have been awarded.
Pfizer has called for Clinical research proposals that aim to increase the understanding of the mechanisms of tobacco and nicotine dependence and its treatment. The overall mission of the GRAND program is to advance the pharmacological treatment of tobacco and nicotine dependence.
Each proposal should fall into one of the following areas:
- Human laboratory (e.g., pharmacokinetics, pharmacodynamics, cravings, withdrawal);
- Pharmacotherapy of smoking cessation and relapse, and / or its interaction with behavioral support;
- Characterization of subtypes of smokers; suitability for appropriate interventions.
Research projects should aim to provide information that could directly advance the use of pharmacotherapy for treating users of any nicotine or tobacco product in clinical practice. Examples could include:
- Observational or interventional studies of pharmacotherapy
- Optimization of the use of currently available medication
- Effectiveness of pharmacotherapy in real-life settings
- Development or use of new medications for cessation or harm reduction
- Specifically designed pharmacotherapy in subtypes of tobacco/nicotine users
- Use of existing databases to inform the clinical use of pharmacotherapy
- Policy interventions to increase use of pharmacotherapy.
The intent of the program is to fund at least 6 awards of between $50,000 and $200,000 in value, totaling $1.2 million. The awards are open to all investigators and they would strongly encourage applications from junior investigators.
Applications will be formally assessed by, and only by, the GRAND Review Committee, an independent committee comprising internationally prominent researchers in the field. The final responsibility for selection of Awardees rests with the Co-Chairs of the Review Committee, John Hughes and Karl Fagerstrom. The whole process is completely independent of Pfizer, including the final selection of Awardees.
GRAND is open to all investigators from around the world holding an MD, a PhD, or equivalent.
Application deadline: July 3, 2017
To apply for the grant and for more information on the application process click here!
A Cochrane Review published today finds standardised tobacco packaging may lead to a reduction in smoking prevalence and reduces the appeal of tobacco.
According to the World Health Organisation, tobacco use kills more people worldwide than any other preventable cause of death. Global health experts believe the best way to reduce tobacco use is by stopping people starting to use tobacco and encouraging and helping existing users to stop.
The introduction of standardised (or ‘plain’) packaging was recommended by the World Health Organisation, Framework Convention on Tobacco Control (WHO FCTC) guidelines. This recommendation was based on evidence around tobacco promotion in general and studies which examined the impact of changes in packaging on knowledge, attitudes, beliefs and behaviour. Standardised tobacco packaging places restrictions on the appearance of tobacco packs so that there is a uniform colour (and in some cases shape) with no logos or branding apart from health warnings and other government-mandated information, and the brand name appears in a prescribed uniform font, colour and size.
From next month, UK legislation on standardised packaging for all tobacco packs comes into full effect.
Australia was the first country in the world to implement standardised packaging of tobacco products. The laws, which took full effect there in December 2012, also required enlarged pictorial health warnings.
A team of Cochrane researchers from the UK and Canada have summarised results from studies that examine the impact of standardised packaging on tobacco attitudes and behaviour. They have today published their findings in the Cochrane Library.
Exposing children to secondhand tobacco smoke (SHS) causes significant harm and occurs predominantly through smoking by caregivers in the family home. Researchers from UKCTAS at the University of Nottingham trialed a complex intervention designed to reduce secondhand smoke exposure of children whose primary caregiver feels unable or unwilling to quit smoking.
This was an open-label, parallel, randomised controlled trial carried out in deprived communities around Nottingham City and County.
The trial worked with caregivers who live in Nottingham City and County in England who were at least 18 years old, the main caregiver of a child aged under 5 years living in their household, and reported that they were smoking tobacco inside their home.
The research compared a complex intervention that combined personalised feedback on home air quality, behavioural support and nicotine replacement therapy for temporary abstinence with usual care.
The primary outcome was change in air quality in the home, measured as average 16–24 hours levels of particulate matter of <2.5 µm diameter (PM2.5), between baseline and 12 weeks. Secondary outcomes included changes in maximum PM2.5, proportion of time PM2.5 exceeded WHO recommended levels of maximum exposure of 25 µg/mg3, child salivary cotinine, caregivers’ cigarette consumption, nicotine dependence, determination to stop smoking, quit attempts and quitting altogether during the intervention.
Geometric mean PM2.5 decreased significantly more (by 35.2%; 95% CI 12.7% to 51.9%) in intervention than in usual care households, as did the proportion of time PM2.5 exceeded 25 µg/mg3, child salivary cotinine concentrations, caregivers’ cigarette consumption in the home, nicotine dependence, determination to quit and likelihood of having made a quit attempt.
The team concluded that by reducing exposure to SHS in the homes of children who live with smokers unable or unwilling to quit, this intervention offers huge potential to reduce children’s’ tobacco-related harm.
This trial was funded by the UK National Institute for Health Research.
To find more information about this trial and the Smoke Free Homes project click here.
Public Health England and NHS England are hosting three one-day events with a practical focus on the current challenges and how they can be met, discussing implementation of tobacco control interventions and how the NHS can make its contribution, to the benefit not only of millions of smokers but its own sustainability.
London – Tuesday 4 April
Leeds – Wednesday 26 April
Birmingham – Thursday 4 May
Smoking rates in England have been declining steadily in the general adult population in recent years (17%), falling further and faster among young people (8%). However, hidden behind this success is slower progress among certain population groups, including individuals with mental health problems and those on lower incomes. Large geographical variations also remain, including amongst women who smoke during pregnancy.
Smokers from all groups are likely to be high users of healthcare services, with significant financial and capacity related implications. Addressing this will be key to ensuring NHS sustainability.
Reducing smoking is key to ensuring NHS sustainability and with the new national CQUIN for addressing risky behaviours (alcohol and tobacco) and local Sustainability and Transformation Plans, there is a fresh impetus for collective action to reduce the health inequalities caused by smoking.
- to explore opportunities for action across the local system to engage with smokers and support them to quit, tackling health inequalities and reducing the burden on the NHS and social care of smoking-related disease.
- identify key areas for joint action to tackle smoking and reduce health inequalities
- understand where smokers are accessing the healthcare system and how this impacts on primary and secondary care services
- consider the ways in which healthcare professionals can integrate treatment for tobacco dependence into routine care and support smokers to quit
Who should attend?
- local authority and NHS commissioners
- CCG leads for acute care, mental health and maternity
- healthcare and service providers
- those with responsibility for managing: Commissioning for Quality and Innovation (CQUINS), delivery of Sustainability and Transformation Plans (STPs), implementation of the stillbirth reduction care bundle
- regional strategic leads for health improvement and clinical networks
More information and registration!
Developing and testing peer-led interventions to promote switching from smoking to vaping.
PhD Studentship ~ Closing date: 26th May 2017
Applications are invited from individuals with a strong academic record who wish to develop a career in behavioural or primary care research. The student will join the thriving Health Behaviours team in the Nuffield Department of Primary Care Health Sciences who are working on range of interventions to support harm reduction and smoking cessation.
The project: The rise in popularity of electronic cigarettes (‘e-cigarettes’) in recent years has been accompanied by a growth in the number of virtual ‘vaper’ communities, with people sharing their advice and experiences of e-cigarettes with peers on internet support groups and discussion forums, many of which address ways of reducing or stopping smoking. The rise of peer to peer support is unique to e-cigarettes; no other means of stopping or reducing smoking attracts such passionate engagement from members of the public. This raises the possibility that we could better harness this peer support to enable more people to reduce or stop smoking using e-cigarettes and this project examines this. Continue reading