New University of Aberdeen research empowers communities to shape smoking prevention and cessation services

04 October 2023

New research led by the University of Aberdeen in collaboration with Turning Point Scotland and NHS Grampian involving people living in areas of multiple deprivation has uncovered powerful community perspectives which could lead to more effective smoking prevention campaigning and higher take-up of NHS free quit smoking services across the region.

Findings from the Participatory Action Research (PAR) entitled ‘Cost of Living, Cost of Smoking: Community Intelligence for Public Health’, funded by ASH Scotland and facilitated by Turning Point Scotland is being revealed during Challenge Poverty Week (2-8 October 2023). The research spotlighted increased financial stress that is exacerbating mental health challenges during the cost-of-living crisis for Banff and Fraserburgh residents who smoke.

Research participants who joined the research study as ‘community partners’ emphasised a need for increased levels of support to be provided to assist individuals to leave tobacco behind, and also strengthen mental health and wellbeing, as they reported a convergence of increased stress from cost-of-living together with higher availability and acceptability of tobacco and related products such as e-cigarettes.

In a dedicated workshop, the group worked with NHS Grampian staff, including from the Health Improvement team, to map the range of currently available services, including the free person-centred support provided by the health board’s specialist Healthpoint ‘Quit Your Way’ smoking cessation service, and explored approaches to further enhance service accessibility and visibility in communities most heavily affected.

Targeting smoking prevention and cessation marketing campaigns to more effectively reach people in communities where there are higher smoking rates, and using incentivising key messages to encourage people who smoke to give up, were identified by research participants as essential steps to improve successful smoking reduction outcomes in the region and tackling root causes connected to stress and mental wellbeing.

NHS Grampian’s senior management has already been engaged with the community intelligence and the health board has responded by committing to work closely with the communities in Banff, Fraserburgh and elsewhere experiencing multiple deprivation to ensure that services which can significantly improve health reach those who need support and help deliver greater outcomes in tackling inequalities.

Amanda Stephen, Turning Point Scotland, said: “It was a pleasure to be a part of this research study and to see community members feel fully empowered by having a platform to enable their voices to be heard. We created an environment of inclusion for individuals to safely open up and express their frustrations and views as part of the ‘Cost of Living, Cost of Smoking’ project.

“A peer support service was a key suggestion by participants, and we would welcome any opportunity to be involved in helping to develop such provision through facilitating further input from community voices.”

Dr Lucia D’Ambruoso, Senior Lecturer at the Institute of Applied Health Sciences, University of Aberdeen, said: “Regular ‘learning spaces’ – bringing people and providers together to generate and act on new evidence – had benefits. Using the Participatory Action Research (PAR) framework, we were able to quickly build new dialogue spaces of trust and respect for pro-equity, community-led, critical and collaborative learning.

“People felt heard, and the process had relevance for different service areas including mental health and health improvement. We are encouraged by the response and planning further co-development and testing.”

Chris Littlejohn, Consultant in Public Health at NHS Grampian said: “The NHS has long aspired to design and develop services with the involvement of those who use them, and as well as providing important new insights into how people might best be supported while trying to free themselves from nicotine addiction, this project has also shown how people can be given genuine influence in the way in which services are delivered.”

Sheila Duffy, Chief Executive of health charity ASH Scotland said: “Smoking rates are disproportionately higher in areas of multiple deprivation in Aberdeenshire and across Scotland, and this new research underscores the importance of prioritising community involvement in shaping smoking prevention and cessation efforts to ensure campaigns and services realise their full potential to maximise impacts and more effectively contribute to helping Scotland to make quicker progress towards becoming a tobacco-free generation.

“Figures show that quit smoking attempts made with support from Scotland’s Quit Your Way services are equally as successful across all levels of deprivation so we’d encourage all health boards across the country to adopt NHS Grampian’s approach to listening to community voices when shaping policy and practice to reduce smoking prevalence, and help more people who want to give up tobacco to overcome inequalities being experienced during the cost-of-living crisis.”