Community-Centred Approach: Fit for the 21st Century

Community-Centred Approach: Fit for the 21st Century

In 2008, the Marmot Review was commissioned to propose the most effective evidence-based strategies for reducing health inequalities in England from 2010. It set out six recommendations to reduce health inequalities to improve health and wellbeing for all. The report provided crucial evidence that to reduce health inequalities in England we must improve community capital and reduce social isolation.

The Marmot Review was published in 2010 and set six recommendations to reduce health inequalities. A framework for action set out the policy goal of enabling society to maximize individual and community potential. Fast forward to 2018 the UK government had by then launched its campaign to put communities at the heart of public health, arguing such approaches can reduce health inequalities, engage those most at risk of poor health, empower people to have a greater say in their lives and health. All with the aim of creating connected, resilient, more cohesive communities.

Yet when such approaches prior to the report had been applied to smoking cessation back in 2008 it had come up with mixed results. Research undertaken by the Cochrane Tobacco Addiction Group suggested that although interventions through the community increased substantial awareness of programmes, they rarely led to higher quit rates. Despite increased knowledge of health risks, changes in attitudes to smoking, more quit attempts, and better environmental and social support for quitting, reductions in community smoking levels were not achieved.

At ROARLABS we recognise that smoking disproportionately affects minority and underserved populations, but only a handful of interventions tailored to these populations have demonstrated effectiveness in real-life situations. Other approaches had since been tried too. Evidence from 2016 concerning integrated lifestyle services that target multiple risk behaviours, such as diet, physical activity, alcohol use and tobacco use collectively, found little evidence that targeting services focused on alcohol use, diet and physical activity, alongside smoking, work as an effective aid to smoking cessation.

But since these poor outcomes for smoking cessation, UK government policy has come on leaps and bounds. In 2019 the UK Health Security Agency launched a short film by leading smoking researcher Dr Lion Shahab an Dr Rosemary Leonard, where they compared the impact of smoking against vaping over one month and the findings were start. Dr Lion Shahab found that using e-cigarettes were significantly less harmful than smoking conventional cigarettes that burn tobacco.


We believe that such approaches, with the right tools, will help reduce health inequalities for the whole community. The Khan Review in 2022 found that without  further action England will miss its smokefree target 2030 by at least 7 years, with the poorest areas in society not meeting it until 2044. At ROARLABS we are setting out plans for a community-centred approach fit for the 21st century that not only provides increased knowledge of health risks, but also evidence-based research that will help ensure community smoking levels are reduced – no matter where you live.

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