NIHRDataInsights/HRCSData huggingface dataset:
Title: Neighbourhood differentials in tobacco pricing across England, Wales and Scotland
Funder: Cancer Research UK

Abstract: Background: We know that tobacco price influences smoking behaviour and neighbourhood differentials in tobacco price help explain geographical variations in smoking rates. Average price, cost of specific brands and how stores absorb the impact of duty rises can vary across neighbourhoods. However, the evidence is equivocal which may be partially accounted for by methodological limitations. Most studies assess tobacco prices through self-report surveys or by visiting stores and recording the sale price of a small number of brands. The proposed study will add substantially to this evidence by using electronic point-of-sale data that captures all tobacco sales in a large sample of convenience stores to examine neighbourhood-level variation in the purchase price of tobacco products across England, Wales and Scotland. Aims: To assess the geographical variation in tobacco price in convenience stores across the country, and how this relates to neighbourhood characteristics. In particular, we will: (1) assess whether tobacco price varies between neighbourhoods differentiated by deprivation, rurality and retail outlet density, and whether there are regional differences in any relationships; (2) examine the extent to which these tobacco neighbourhood price differentials have changed over time (2016-2020); (3) assess the strategies adopted by retailers to absorb/distribute the impact of changes in tobacco duty (including the tobacco duty escalator) across neighbourhoods stratified by neighbourhood characteristics, and by different regions of the country. Methodology: We will extract data obtained through an electronic point-of-sale system on all sales of tobacco in 2,900 convenience stores across England, Wales and Scotland in the first week of every month between January 2017 and July 2020. These data will be combined with neighbourhood-level measures of income deprivation, tobacco retail outlet density (Scotland only) and urban/rural status. We will examine brand price for the most popular cigarette and RYO brands and variations in purchases by price segment; multivariable regression analysis will assess associations between area variables and tobacco price. Results: The findings will include estimates of tobacco price variation across the UK, by deprivation, rurality and retailer density; and documentation of strategies adopted in response to changes in tobacco duties. Findings will inform submissions by advocacy organisations to the UK Treasury to support the case for tobacco duty increases and their effective implementation, and also provide valuable evidence to inform the future development of an MUP for tobacco. Findings will be disseminated to key policy and advocacy organisations including via policy briefings and presentations at key policy forums/seminars.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;RESPIRATORY;STROKE
Title: Cochrane living systematic review of electronic cigarettes for smoking cessation
Funder: Cancer Research UK

Abstract: Background Cochrane reviews are considered the gold standard in evidence synthesis, and the Cochrane review of electronic cigarettes (EC) for smoking cessation informs policy worldwide. Updated in 2016, it found a high degree of uncertainty regarding the effect of EC, due to few included studies and rapid changes in the technology. Thus, conclusions are likely to change as new evidence emerges. Policymakers frequently draw on the review, meaning it is important it is up-to-date, so decisions can be based on the entirety of the evidence. Aims To convert the Cochrane review of EC for smoking cessation into a living systematic review (LSR), to provide an up-to-date, accessible, engaging and unbiased review of the evidence on the effect and safety of using electronic cigarettes to quit smoking. Methods LSRs are based on monthly searches for evidence and are updated regularly to ensure they are responsive to the needs of decision makers. Converting the existing review of EC to an LSR will involve updating the existing review (including documenting methods for maintaining the review as an LSR) and running monthly searches to identify new evidence. Searches, screening, data extraction and critical appraisal will follow standard Cochrane methods and those used in the existing review. Every month, the review status will be updated to highlight whether new evidence has been found. Monthly briefing documents will be created and disseminated. Analyses and the full text of the review will be updated where new data is identified likely to change or strengthen conclusions. We anticipate this occurring every three to four months. Members of the public will help shape the methods and review monthly updates. How the results of this research will be used A vital aim of this project is to ensure the regularly updated information is as useful and usable as possible, particularly for contributing to EC policies. We plan to work closely with CRUK to achieve this. In addition to regular updates of the review on the Cochrane Library, planned outputs include: ‘at-a-glance’ monthly briefing documents; a webpage allowing easy access to new evidence; work to engage parliamentarians; monthly podcasts summarising new evidence; and webinars to coincide with updates that lead to changes in conclusions. At project end, we will review the impact of the LSR approach and the stability of the evidence base, to make an informed decision regarding the future update schedule of the review.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;RESPIRATORY;STROKE
Title: Youth Tobacco Policy Survey (YTPS), Wave 9
Funder: Cancer Research UK

Abstract: Background The Youth Tobacco Policy Survey (YTPS) is a long running repeat cross-sectional survey of 11 to 16 year olds across the UK. In a series of eight surveys since 1999, it has monitored young people’s response to the UK’s increasingly comprehensive tobacco control strategy. It has shown how young people’s smoking knowledge, attitudes and behaviour have changed since the introduction of the Tobacco Advertising and Promotion Act 2002, the removal of smoking in public places; the increase in the minimum age of purchase to 18; the inclusion of pictorial warnings on packs; the implementation of a point-of-sale display ban and legislation banning smoking in cars with under 18’s. Since 2014, it has also been able to assess the impact of e-cigarettes and related regulatory measures. From May 2017, the Standardised Packaging of Tobacco Products Regulations and new Tobacco Products Directive (TPD) transformed the appearance of packs of cigarettes and rolling tobacco. The revised TPD also prohibited the advertising of nicotine-containing, unlicensed e-cigarettes in media with cross-border impact. A further wave of YTPS will be crucial to assess the impacts of these policy developments, alongside the cumulative impacts of earlier policies and the potential impacts of e-cigarette marketing on tobacco control efforts. We propose a final wave of the YTPS in summer 2020, approximately three years post-implementation of standardised packaging and the TPD. Aims The YTPS aims to monitor young people’s response to tobacco control policies and any form of tobacco marketing, as well as their knowledge, attitudes and behaviour in relation to both smoking and e-cigarettes. Method Random location quota sampling is used to select approximately 1150 young people from 92 electoral wards across the UK. In-home face-to-face interviews are conducted by professional market research interviewers using Computer Assisted Personal Interviewing (CAPI), with a short self-completion section for more sensitive measures such as smoking behaviour. The YTPS has included detailed measures on different forms of tobacco marketing and, from 2014, measures on e-cigarettes and baseline measures for monitoring standardised packaging. How the results will be used A final wave of the YTPS would provide a unique dataset covering the whole period when almost all forms of tobacco marketing were gradually removed in the UK. Demonstrating the cumulative effect of these policy shifts on youth smoking could provide valuable data for other countries that have not implemented such marketing restrictions. Dissemination will be via journal articles, presentations, teaching, and meetings.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;RESPIRATORY;STROKE
Title: Tackling Smoking in Wales
Funder: Cancer Research UK

Abstract: Background: Action on Smoking and Health Wales is Wales’s national charity seeking to reduce the harm and inequality caused by tobacco. Wales is formulating a new tobacco control plan which sets the course of actions for the next decade. The plan currently aims to make Wales smoke-free (less than 5% smoking prevalence) by 2030. However, modelling by CRUK in 2020, found this target will not be met until 2037 if the current pace of reductions remains the same, with more deprived groups reaching 5% much later. Under the CRUK model the pace of change needs to be accelerated by 40% for Wales to become smoke-free by 2030. Health inequalities in Wales have shown little improvement in a decade. Therefore any additional needs to focus on addressing those inequalities. Aims: We will work to ensure Welsh Government, Key Opinion Leaders, and stakeholders take action to increase the pace of change and put Wales on track to achieving the endgame target. Method: Our work will support; innovation in cessation solutions that meet the needs smokers with a focus on priority groups; direct action to keep tobacco out of the hands of children by making it less attractive and available and the denormalisation of smoking across all sections of society. We will push for targets to monitor actions progress and hold Welsh Government and stakeholders to account through our position on the Strategy Board. Will will publish research, briefings and respond to key legislative consultations. Provide evidence-led direction to key decision makers, including Welsh Government and work with a wide range of stakeholders to shape policy initiatives and guide the strategic direction of tobacco control in Wales. Through our Cross Party Group we will garner political and stakeholder support and promote an integrated cross-government approach. Through our Tobacco Alliance and tobacco network we will create a collective voice to drive action. Finally, through our surveys and public relations programme we will work to harness civil society action to support the smoke-free Wales vision. Value: Through CRUK’s support for our policy and advocacy work we are able to significantly influence political action on tobacco and health in Wales. ASH Wales and the tobacco alliance have been instrumental in securing a commitment to an endgame target for Wales. With CRUK's support ASH Wales will be able to independently challenge and drive forward tobacco control policies in Wales and ensure that the target is reached.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;RESPIRATORY;STROKE
Title: The Adult Tobacco Policy Survey: Understanding how smokers and ex-smokers respond to tobacco control policies in the UK
Funder: Cancer Research UK

Abstract: Background: Smoking cigarettes, whether factory-made or hand-rolled, remains the leading cause of cancer death in the UK. To discourage smoking the UK Government has introduced a range of tobacco control policies. Evaluating the impacts of these policies is crucial to understanding whether they may help to reduce tobacco-related morbidity and mortality. Aim: To conduct a fourth wave of the Adult Tobacco Policy Survey (ATPS) to explore the response of adult smokers and ex-smokers to three major tobacco control policies in the UK: 1) Standardised packaging, mandatory since 20th May 2017; 2) New health warnings on packs, phased in from 1st January 2021, and 3) A ban on menthol cigarettes, mandatory since 20th May 2020. Methods: The ATPS is a longitudinal online survey, conducted in April–May 2016 (Wave 1), September–November 2017 (Wave 2), and May–July 2019 (Wave 3). All participants at Wave 1 (N=6233) were smokers, with the sample weighted by age, gender, government office region, and tobacco consumption, to represent the national profile of smokers aged 16 and over across the UK. Participants were followed up at subsequent waves, whether they continued to smoke or had quit, with 4293 participants at Wave 2, 3195 at Wave 3, and 2400 predicted at Wave 4 (October-November 2022). The ATPS is the only UK-wide longitudinal survey that permits the impacts of these three policies to be explored. How the results will be used: A fourth wave of the ATPS would allow us to explore: 1) Smokers’ cognitive, emotional and behavioural response to standardised packs; 2) Whether standardised packaging may help prevent relapse among ex-smokers; 3) Any association between standardised packaging and illicit tobacco use, 4) The impact of new warnings on packs on warning salience and effectiveness and cessation-related behaviours; and 5) How menthol cigarette smokers responded to the menthol ban. These findings will be communicated primarily through academic publications, policy briefings, and oral presentations to policy makers and academic audiences. The findings will be extremely important for policy makers across the UK, allowing them to better understand the impact of domestic tobacco control policies, and of significant value to policy makers in countries considering these policies.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;RESPIRATORY;STROKE
Title: Electronic cigarettes and use of combustible tobacco products in young people: a Cochrane systematic review
Funder: Cancer Research UK

Abstract: BACKGROUND The relationship between the use of e-cigarettes and combustible tobacco products among young people is highly contested. Longitudinal studies have shown associations between e-cigarette use and smoking uptake, but it is uncertain whether the relationship is causal, with different studies drawing different conclusions. Given the relevance of this question to cancer prevention and public health, an unbiased, robust, and thorough review of the available evidence is urgently needed to inform policy and interventions, as well as to guide future research. We propose conducting a Cochrane review of this topic and conducting a consensus exercise to come up with a set of recommendations to guide conduct and reporting of future research in this area. AIMS Our objective is to assess the relationship between the use and availability of e-cigarettes and tobacco smoking behaviour in young people =29 years), and draw on this to inform further research in this area. This translates into three aims and associated outcomes: (1) create a comprehensive, critically-appraised resource of literature evaluating the relationship between vaping and tobacco smoking in young people; (2) synthesise data to evaluate potential causal relationships between vaping and tobacco smoking, and whether the relationship differs by socially-stratifying characteristics; (3) make recommendations to guide future research in this area. METHODS Methods will follow those set by Cochrane, but will also be shaped by ongoing discussions with key stakeholders and members of the public, who have already provided input. Study types will include observational studies (including longitudinal cohorts, interrupted time series, and instrumental variable studies); outcomes will include population rate of tobacco use in young people and cessation, uptake or progression of combustible tobacco use in young people. Key activities include: (1) developing and publishing the review protocol; (2) running literature searches and issuing a call for unpublished evidence; (3) screening studies for inclusion; (4) extracting data and critically appraising studies; (5) creating an evidence map; (6) synthesising data by drawing on causal-chain and temporal qualitative analysis techniques; (7) making recommendations for future research drawing on review findings and a consensus exercise (survey and workshop); (8) publish and disseminate findings. HOW THE RESULTS OF THIS RESEARCH WILL BE USED This review has the potential to not only develop new knowledge in an area where opinions dominate over evidence but crucially to be used as a trusted source of information by those developing e-cigarette policies, and as a driver for further high quality research.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;RESPIRATORY;STROKE
Title: Building back tobacco-free
Funder: Cancer Research UK

Abstract: Building back tobacco-free Background Smoking is the biggest cause of preventable ill-health and early death in Scotland, leading to 100,000 hospitalisations and over 9,000 deaths, some 16% of all deaths. Smoking rates in our poorest communities stand at 32% compared to 6% in our most affluent. Attention and capacity were diverted from tobacco issues by COVID-19. Aims ASH Scotland aims to raise the profile of tobacco issues at national level in Scotland, generating commitment to strategic leadership and effective actions to reduce tobacco use and tobacco related inequalities and tackle tobacco harms. Methods Drawing on our experience and expertise as the national independent Scottish charity on tobacco issues, ASH Scotland will bring evidence, analysis and good practice examples to our influencing and advocacy work and policy analysis. We will work in partnership to build consensus and motivate effective action amongst key policy makers and partners in Scotland. Value We aim to see delivered: - Legacy tobacco actions from 2013 and 2018 national strategy and action plan completed, - Partnerships in action and influence built in Scotland, - a strong new Scottish tobacco action plan launched in 2023, - evidence of progress in tackling tobacco-related inequalities


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;RESPIRATORY;STROKE
Title: Integrating online smoking cessation treatment as part of NHS routine psychological care for people with common mental health problems: a randomised feasibility and pilot study
Funder: Cancer Research UK

Abstract: Background: Smoking is the UKs leading cause of preventable cancer. One in every two smokers will die of a smoking-related disease unless they quit, and 15% of all cancers in the UK are caused by smoking. Smoking prevalence is twice as high in people with mental illness compared to the general population. Quitting smoking can lead to significant improvements in mental health. However, smoking cessation treatment is not currently integrated into NHS routine care for common mental illness, known as IAPT. Integrating these treatments would help to reduce smoking prevalence, reduce health inequalities, and improve mental health. IAPT patients are initially offered online CBT via a platform called SilverCloud. SilverCloud is incorporated in more than 75% of NHS IAPT services, and has treated 450,000 people in England. Computerised interventions for smoking cessation are effective and such a platform could describe the mental health benefits of stopping smoking, and proprovide an appropriate method to improve smoking cessation rates in people with mental illness at a low cost. In light of the COVID-19 pandemic, health services are urgently looking for novel and remote ways to deliver health services to their patients. Aims: 1. Co-design an online smoking cessation intervention that can be integrated IAPT’s SilverCloud. 2. Investigate the acceptability and feasibility of the online intervention, and trial procedures in an online randomised pilot and feasibility trial. 3. If the intervention is acceptable and feasible, we will use the outputs to apply for funding for a full RCT. Methods: Using experience-based co-design methods we will collaborate with patients and other stakeholders and conduct qualitative research to develop an online smoking cessation intervention, and trial procedures. The intervention will be based on co-design, NICE guidelines, NCSCT Standard Treatment Programme for smoking cessation. The intervention will likely be an optional SilverCloud ‘module’, in which the participant will be offered behavioural smoking cessation treatment, and smoking cessation medicine. We will then conduct a parallel two-arm, pragmatic, online randomised and controlled, feasibility and pilot trial of this intervention, with nested qualitative research. Primary outcome will be engagement with the smoking cessation intervention. How the results will be used: We will feedback to participants, patients and services who helped design and run the trial, and to mental health charities. Results will be peer-reviewed and co-authored with IAPT patients, then disseminated by submitting to open-access journals, open-science platforms, conferences and media. These results hope to inform a RCT to test intervention effectiveness.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;RESPIRATORY;STROKE