Addressing alcohol and tobacco harm
We have achieved significant nation-wide impact in alcohol and tobacco policy, motivated by addressing harmful effects on health and underlying socio-economic inequalities.
Tobacco and alcohol use pose significant global public health challenges and are major determinants of preventable morbidity and mortality. Globally, 7 million lives are lost each year to tobacco-related illness and a further 3.3 million to alcohol-related illness.
In Scotland, these concerns are particularly acute. The alcohol-related death rate in Scotland is twice that of England, with one in every 20 deaths attributable to alcohol. Smoking rates in Scotland are also the highest in the UK, with one in every five deaths attributable to smoking. As a result of these statistics, tobacco and alcohol consumption were selected as two key indicators used to monitor progress in the Scottish Government's National Performance Framework.
The Centre for Research on Environment Society and Health (CRESH)
Professors Niamh Shortt and Jamie Pearce are co-directors of CRESH, exploring how physical and social environments can influence population health, for better and for worse.
Our research through CRESH evidences how tobacco and alcohol retail availability is related to health harm and addresses the over-provision of alcohol and tobacco products in Scotland . We work closely with advocacy organisations and policymakers across the UK, particularly those responsible for tobacco, alcohol and healthy ageing-related policies.
CRESH research has utilised rich secondary datasets to demonstrate a spatial association between tobacco and alcohol retail availability and socio-economic deprivation. We have shown a strong social gradient in the availability of tobacco and alcohol products in Scotland. There are more outlets in the most socially deprived neighbourhoods when compared to the most affluent neighbourhoods.
Our research shows that in Scotland, the local availability of alcohol and tobacco is strongly associated with health-related behaviours, health harms and deaths.
| Smoking |
We have demonstrated that teenagers living in areas with the highest density of tobacco outlets are more likely to smoke or experiment with smoking. Adults in these areas are more likely to smoke. |
| Alcohol |
Findings confirm that in Scotland, hospitalisation rates and deaths from alcohol-related illness are highest in areas with the highest density of alcohol retailers. This effect is demonstrated at both national and local scales. Furthermore, research has shown that those in the lowest income groups are disproportionately affected by alcohol outlet density, revealing the greatest harms when alcohol availability increases. |
Influencing policy and decision-making
Our research has been instrumental in shaping national-level strategies around harm reduction and steered government policy and national advocacy charity responses. Findings have also directly impacted decision-making about local retail environments to prevent harm and reduce health inequalities.
As a result, we are:
- influencing key national approaches to addressing alcohol and tobacco harm
- influencing the alcohol licensing process and decision-making outcomes
Our research has contributed directly to government-level strategic approaches to addressing the harms of alcohol and tobacco in Scotland. This has been achieved through targeted efforts to raise awareness and understanding of the links between outlet density and mortality and morbidity.
Our research findings through CRESH have been embedded in strategic policy development of the Scottish Government, Public Health Scotland and the key national-level advocacy organisations in the areas of alcohol and tobacco.
Public Health Scotland
Significantly, our work has been instrumental in shaping the Scottish Government's strategic priorities of Scotland's newly formed national public health body, Public Health Scotland. Our research findings and recommendations have been embedded in the strategic policy development of Public Health Scotland in the areas of alcohol and tobacco.
Our work has also inspired further research and action being commissioned by Public Health Scotland and Cancer Research UK.
You can learn more about Public Health Scotland's work on alcohol and tobacco on their website.
Scottish Government
Our research has been influential in shaping the Scottish Government strategies, in particular:
- 'Raising Scotland's tobacco-free generation: our tobacco control action plan'
- 'Alcohol Framework 2018'
As a result of our combined research efforts, we have recently influenced the content of key elements of the Scottish Government's strategy and forthcoming legislation addressing alcohol and tobacco harm. In particular, addressing availability was identified by the Government as a key policy priority, with this new direction heavily influenced by our research.
Professors Shortt and Pearce have presented research findings to key policymakers in the Scottish Government, including:
- invited members of the NHS Scotland Advisory Group, Tobacco Pricing and Availability
- engaging directly with MSPs through invitations to speak at meetings of various Cross-Party Groups at the Scottish Parliament
- Professor Shortt was invited to provide evidence to the Local Government and Regeneration Parliamentary Committee when discussing the Air Weapons and Licensing (Scotland) Bill
- Professor Pearce has given invited presentations to the Tobacco Control: Research and Evaluation Sub-Group (Scottish Ministerial Working Group on Tobacco Control)
As a result of our work and engagement with policymakers, some of our highlights also include:
- Our evidence presented to the Licensing (Scotland) Bill was used by the Member of the Scottish Parliament (MSP) Labour Mid Scotland and Fife to draft an amendment that would compel the Scottish Government to develop a national register of licensed premises. As a consequence, the Government promised to consult widely on the issues identified in the debate.
- Our work has received two Parliamentary commendations in motions lodged by MSPs and signed by a total of 36 MSPs.
- The research has also been cited in at least two Parliamentary sessions, demonstrating a shift in the political commitment to addressing the harms of ubiquitous alcohol availability.
You can read more about Scotland's public health priorities on the government website.
Work by our researchers has been instrumental in affecting decision-making relating to alcohol licensing in Scotland.
There are 32 Licensing Boards in Scotland. As a regulatory standard, each Licensing Board is required to produce overprovision statements every four years.
- In 2019, at least 13 specifically cited and used the data developed by Professors Shortt and Pearce.
- At least four Licensing Boards, including North Ayrshire, South Lanarkshire, Stirling and West Dumbartonshire, formally declared their council to be over provided.
When an area is declared over provided for in terms of alcohol, then any further alcohol license applications in the area should normally be refused. Each of these council areas has explicitly related their overprovision decision to the research and data developed by Professors Shortt and Pearce. These informed decisions are helping to reshape local environments with the potential to improve health.
Research by CRESH is also being used by local stakeholders to inform Licensing Boards considering applications for new alcohol licences. In at least one Licensing Board, an alcohol licence has been refused based on the research. The Alcohol and Drug Partnership East Ayrshire noted that the objection was based on CRESH research data and alcohol risk environments study.
Our research has also been critical in shaping various local alcohol strategies, including:
- Edinburgh Alcohol Strategy (2017-19)
- Borders Alcohol and Drugs Partnership Annual Report (2017-18)
- The Alcohol Policy Review (2018) Impact on Moray Report
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Population, Health and Place Research Group This group supports researchers with broad interests in the relationships between place, health and well-being. |
Visit the Population, Health and Place research group |
Research institute
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Geography and the Lived Environment Institute Our Geography and the Lived Environment Institute is comprised of geographers and environmental scientists who study the social, cultural, political, economic and physical processes that create and reshape the world. |
Geography and the Lived Environment Institute |
Find out more about our work through the Centre for Research on Environment Society and Health (CRESH) on the website.