Appendix D: gaps in the evidence

Appendix D: gaps in the evidence

The PDG identified a number of gaps in the evidence related to the programmes under examination, based on an assessment of the evidence. These gaps are set out below.

  1. Data routinely collected by the NHS Stop Smoking Services are not particularly helpful as an aid to improving the service. For example, although reducing prevalence among people in routine and manual groups is a priority, information on occupation is not part of the minimum data set required by the DH.

  2. Certain groups, such as pregnant women, routine and manual workers and people living in institutions, face substantial barriers to quitting smoking. Research is needed to provide a fuller picture of the effectiveness and cost effectiveness of smoking cessation services for these groups. In particular, the cost effectiveness of home visits by specialist stop smoking professionals for pregnant women who smoke should be compared with the women attending stop smoking clinics, using NRT or attempting to quit without assistance.

  3. Although some commercial smoking cessation treatments may be effective, there is little or no evidence of effectiveness from high quality, comparative trials.

  4. New media such as text messaging and podcasts are potentially effective in delivering personalised advice to people who smoke. However, more published evidence of their longer-term impact is needed.

  5. More information is needed on the impact of mass media smoking cessation messages on people who smoke who are pregnant, socio-economically disadvantaged or from a minority ethnic group.

  6. More information is needed about both the cost-effectiveness of workplace interventions and their long-term effectiveness, particularly in the context of widespread smoking restrictions.

  7. More information is needed about the long-term benefits to employers of providing workplace smoking cessation support.

  8. More information is needed on the cost effectiveness of using specially trained midwives to deliver smoking cessation advice to pregnant women who smoke compared with:

    • home visits by specialist stop smoking professionals

    • attending stop smoking clinics

    • attempting to quit without assistance.

The Group made six recommendations for research. These are listed in section 6.