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22/79 Stop-smoking interventions for under-served groups


Published: 28 June 2022

Version: 1.1

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Please note, the Public Health Research (PHR) Programme would like to draw researchers’ attention to the commissioning brief below, which was first advertised in Summer 2022. This is a brief that we have previously advertised as a commissioned funding opportunity. We are still interested in receiving applications in this research area, as it remains a priority in our portfolio. However, please note that the commissioning brief, along with the underpinning literature searches, has not been updated since originally written.

Research question

  • How can effective and cost-effective interventions to support people to stop smoking be modified to improve engagement with and accessibility for under-served groups? How acceptable are these interventions to these groups?

The NICE guideline [NG209] ‘Tobacco: preventing uptake, promoting quitting and treating dependence’ was published in November 2021. The guideline covers support for smoking cessation for everyone aged 12 years and over.

Smoking remains the leading cause of preventable illness and premature death in the UK. Moreover, nearly half of all lifelong smokers die prematurely, losing on average over 10 years of life, with more years lost to ill health. Overall smoking prevalence has declined; however, a high smoking prevalence is still seen in some populations that may not be well served by existing stop-smoking services, leading to widening inequalities.

Under-served groups are defined by NICE as ‘groups who may be less likely to benefit from an intervention because they have specific needs that the intervention does not address, or because they may face additional challenges in engaging with the intervention’. Under-served populations include for example, people with mental health conditions, people identifying as LGBTQ+, or people on low income. Guidance on improving inclusion of under-served groups in research can be found here.

NICE found no evidence on how to tailor effective and cost-effective interventions to ensure that they are engaging and accessible for under-served groups. Moreover, NICE found no evidence on how acceptable those interventions may be for these groups. This is an important research gap that needs to be addressed to reduce health inequalities.

The Public Health Research (PHR) Programme wishes to commission research to fill this evidence gap. The PHR programme is predominantly interested in interventions that are likely to have impact on populations at scale, and that address health inequalities and the underlying wider determinants of health. The PHR Programme recognises that interventions are likely to impact different (sub)populations in different ways, and encourages researchers to explore such disparities in their study design.

Suggested research areas of interest could include (but are not limited to):

  • The modification of interventions that support people to stop smoking to improve engagement and accessibility for under-served groups
  • Exploration of the acceptability of these interventions to under-served groups

Interventions can include those utilising e-cigarettes, although please note that e-cigarettes are not licensed as medicines in the UK. The PHR programme recognises that e-cigarettes are nevertheless being commissioned and used in various settings.

A range of study designs and outcome measures can be used. Researchers will need to clearly describe and justify their choice of target population group, and their methodological approach. Primary outcomes must be health related. Outcome measures of interest may include smoking status, subjective wellbeing, physical health, quality of life, depression, anxiety, sleeping problems, or life satisfaction. Researchers are encouraged to consider other outcome measures including the broader determinants of health inequalities, which should be specified and justified. Researchers will also need to specify key outcomes and how these will be measured in the short, medium and long term.

Understanding the value of public health interventions - whether the outcomes justify their use of resources - is integral to the PHR programme, where resources relating to different economic sectors and budgets are potentially relevant. The main outcomes for economic evaluation are expected to include health (including health-related quality of life) and the impact on health inequalities as a minimum, with consideration of broader outcomes welcomed. Different approaches to economic evaluation are encouraged as long as they assess the value and distributive impact of interventions. Applications that do not include an economic component should provide appropriate justification.

Researchers are strongly encouraged to ensure that service users or people with lived experience from the target audience and decision-makers are involved in the design and planning of the intervention and/or as potential costed members of the research team. Researchers should demonstrate the relevance of their proposed research and are encouraged to explain how they will share their findings with policy makers, public health officers, special interest groups, charities, community audiences and other relevant stakeholders. Researchers are expected to be aware of other studies in this area and ensure their proposed research is complementary.

For further information on submitting an application to the PHR Programme, please refer to the supporting information for applicants submitting Stage 1 and Stage 2 applications.