REF2014 Impact Case Study: The Smoking Epidemic in England and Scotland: Shaping Public Health Policy and Planning

Impact: Health & Welfare Impacts

Description of impact

Research undertaken at the University of Portsmouth has 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.

Who is affected

Health Authorities; General Public


Our research addressed the lack of good quality local information needed to inform public health policy and target cessation campaigns effectively establishing, evaluating and applying an innovative technique for generating predictions of health behaviour for small areas called multilevel small area synthetic estimation (MLSASE).
Part of the impact chain in shaping public health outcomes and policy begins with the publication of the Twigg et al, 2004 ‘Smoking Epidemic’ report. The headline figures were used in February 2006 to open the debate on the Health Bill that eventually led to the ban of smoking in enclosed public places in England. Evidence suggests that this legislation has led to improvements in health in the current REF period and has resulted in a change of attitude towards smoking behaviour. Although the rationale for policy change focused on health benefits for non-smokers, according to the Smoking Toolkit Study, adult smoking prevalence has reduced from 24.1% in 2007 to 20.6% in 2011. Findings have also informed anti-smoking campaigns led by health authorities, charities and pressure groups.
Impact statusOpen
Category of impactHealth & Welfare Impacts
Impact levelBenefit (delivered impact)


  • smoking


  • REF2014