1 The role of interventions and policies to promote behaviour change University College London June 2014 Robert West

Declaration of competing interests I undertake research and consultancy for companies that develop and manufacture smoking cessation medicines and licensed nicotine products I am a trustee of the charity, QUIT I am an honorary co-director of the National Centre for Smoking Cessation and Training My salary and most of my research is funded by Cancer Research UK 2

Major causes of disability and premature death globally 3 Lim et al 2012 Lancet

Major causes of disability and premature death globally 4 Lim et al 2012 Lancet Behaviour change is of critical importance in addressing all of these

The COM-B model of behaviour 5 Changing behaviour requires changing one or more of three underpinning elements, either directly or indirectly Michie et al (2011) The Behaviour Change Wheel, Implementation Science

The COM-B model of behaviour 6 Enhance Motivate: Facilitate: educate, train, enable persuade, incentivise, coerce, model restructure the environment, set up rules

Criteria for choosing a behaviour change intervention Acceptability Practicability Effectiveness/cost-effectiveness Affordability Safety/side-effects Equity 7 Michie et al (2014) The Behaviour Change Wheel: A Guide to Developing Interventions. London: Silverback Publishing

Tobacco control: evidence-based approaches Intervention typePolicy implementation EducationBrief health professional advice EnablementBehavioural support/counselling, pharmacotherapy PersuasionMass media campaigns, graphic health warnings CoercionTaxation and control of illicit supply RestrictionBanning sale to under 18s, indoor smoking ban Environmental restructuring Banning tobacco marketing and promotion 8 West R (2010) Evidence-based tobacco control: why England still needs it and what it is. In Arnott D (Ed) All Party Parliamentary Group Report on Tobacco Control in England. London: ASH

Cigarette smoking trends: worldwide and in the UK 9

Latest trends in England 10

The global challenge for tobacco control Top priorities 1.Raise tobacco taxes and control illicit supply 2.Mount sustained mass media campaigns 3.Ban tobacco marketing and promotion 4.Prevent sales to minors 5.Train health professionals in brief tobacco cessation advice 6.Facilitate access to cheap stop-smoking medicines (e.g. cytisine) 7.Do not block access to safer alternatives (e.g. e- cigarettes, snus) 11

The global challenge for behaviour change Creating political and economic structures that motivate and facilitate populations to engage in behaviours that enhance wellbeing Requires a systematic application of behavioural science involving theory and evidence 12

13 Thank you for your attention