The role of interventions and
policies to promote behaviour
change
Robert West
University College London
June 2014
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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
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Major causes of disability and premature death
globally
Lim et al 2012 Lancet 380 2224
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Major causes of disability and premature death
globally
Behaviour change is of critical
importance in addressing all of
these
Lim et al 2012 Lancet 380 2224
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The COM-B model of behaviour
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
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The COM-B model of behaviour
Enhance
educate, train, enable
Motivate:
persuade, incentivise,
coerce, model
Facilitate:
restructure the
environment, set up rules
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Criteria for choosing a behaviour change
intervention
•
•
•
•
•
•
Acceptability
Practicability
Effectiveness/cost-effectiveness
Affordability
Safety/side-effects
Equity
Michie et al (2014) The
Behaviour Change Wheel: A
Guide to Developing
Interventions. London: Silverback
Publishing
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Tobacco control: evidence-based approaches
Intervention type
Policy implementation
Education
Brief health professional advice
Enablement
Behavioural support/counselling, pharmacotherapy
Persuasion
Mass media campaigns, graphic health warnings
Coercion
Taxation and control of illicit supply
Restriction
Banning sale to under 18s, indoor smoking ban
Environmental
restructuring
Banning tobacco marketing and promotion
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
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Cigarette smoking trends: worldwide and in
the UK
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Latest trends in England
Cigarette smoking prevalence
30
25
24.2
22.0
21.5
20
21.4
20.7
20.0
19.3
18.2
15
10
5
0
2007
2008
2009
2010
2011
2012
2013
2014 (Apr)
(N=22079) (N=18990) (N=21137) (N=24794) (N=21879) (N=21330) (N=22167) (N=6775)
www.smokinginengland.info
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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. ecigarettes, snus)
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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
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Thank you for your attention
www.behaviourchangewheel.com
www.ucl.ac.uk/behaviour-change
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