Data and Dialogue

We present evidence on the cost of smoking in the current cost of living crisis in 2023. We work in the rural northeast of Scotland where high levels of deprivation are measured on multiple fronts.

We have progressed a Participatory Action research (PAR) demonstration study to: (i) convene community experts to understand local health priorities; (ii) understand health issues from different perspectives and generate new data on these. We work with community and data experts to build shared capabilities in PAR tools, techniques and practical skills.

Diverse forms of evidence are the foundation for dialogue and exchange between community actors, service providers, researchers and policy advocates. The real value of the process lies in the development of shared understanding between diverse actors as a catalyst for change.

The research is informed by a wider 'prospective policy analysis' lens, described by Buse as:

"...engaging technical, scientific experts, programme managers, decision-makers and the public to collectively weigh various types of evidence ... in collaborative analysis of policy options"

"Decision-makers will not only benefit from greater proximity to technical experts but also from better evidence ... which can inform tactics to bring about change."

(Buse, 2008)

Problem Statement

"No means to break the cycle"

We mapped the convergence of increased stress from the financial crisis, and increased availability of smoking products in communities. We used the 'Problem Tree' tool to understand and ‘unpack’ topics from different perspectives and systematise our subjective experiences into collective forms of knowledge.

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Statistical Data

Our statistical analysis highlighted smoking as a social problem. We present statistical analyses of routine and adminsitrative data together with population health indicators. Different datasets are disaggregated by wealth, education and other social markers. Taking an intersectional approach, we aim to understand smoking and smoking related illness in context.

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Stakeholder Analysis

"The individual is a grain of sand"

Services did not appear to be immediately accessible in the under-served communities where we worked. We mapped relationships and interactions between various actors and institutions. We explored how individual willpower needs to be met with accessible services. Combined with macro level factors and forces, these constrain people's agency for cessation.

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Evidence Reviews

We performed rapid evidence reviews on topics of relevance in local communities and surfaced through community dialogue. We present 3 rapid reviews on the evidence for: (1) hypnosis and (2) e-cigarettes as supports for cessation. We also reviewed debates on (3) how to talk about poverty in research based in under-served communities.

Review 1: Hypnosis for Cessation

Review 2: E-Cigarettes

Review 3: Language on Poverty

Visual Evidence

We visually conveyed lived experience using a method called Photovoice. We took photographs illustrating the topics as they exist in our lived and physical environments. We present and discuss visual data, with captions we developed to describe what images convey.

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Action Agenda

Our action reflection is collectively developed to represent moving towards a desired goal via a series of interconnected steps and events. We reviewed alternative courses of action and specified and appraised interventions, their feasibility and acceptability, and potential barriers including cultural factors.

The Future We Want