Conceptualising changes to tobacco and alcohol policy as affecting a single interlinked system

Lead investigators: Dr Duncan Gillespie and Dr Jenny Hatchard

Why this is important

To support a move towards a coordinated non-communicable disease approach in public health policy, it is important to conceptualise changes to policy on tobacco and alcohol as affecting a single interlinked system. For health economic models to effectively inform policy, the first step in their development should be to develop a conceptual understanding of the system complexity that is likely to affect the outcomes of policy change. Our aim in this study was to support the development and interpretation of health economic models of the effects of changes to tobacco and alcohol policies by developing a conceptual understanding of the main components and mechanisms in the system that links policy change to outcomes.

What we found

The paper has been published in BMC Public Health (Gillespie et al. 2021) and summarised on the SPECTRUM website. The qualitative data that the publication is based on is here (Gillespie et al. 2020).

Who was involved

Academics (from UK research networks) and policy professionals (from UK government agencies or non-governmental organisations involved in health advocacy). We did not involve lay members of the public at this initial stage.

What we did

We started off by conducting a rapid review of the literature on the joint effects of tobacco and alcohol policies and by surveying our participants to find out their initial thoughts. Download our pre-workshop research.

This led us to define five policy themes (Price, Place, Person, Promotion, Prescriptive) and a cross-cutting theme of Industry Regulation. Then came the workshop in which a group of 21 academics and policymakers discussed how public health policies for tobacco and alcohol work in practice. Download our workshop programme. and our guidance to workshop facilitators.

There was a lot of vibrant and detailed discussion as participants constructed diagrams of how they saw the different policies within our five policy themes affecting smoking and drinking. Everyone at the workshop took notes as they went, which we later analysed in preparation for publication of our findings and for using the outcomes as the foundations for our health economics modelling for tobacco and alcohol. Discussions focused around constructing a diagram on flipchart paper. After lunch, each group rotated around the other policy themes, giving feedback and extending the discussion.


Funded by UKCTAS, NIHR School of Public Health Research, and the Institute of Alcohol Studies


Gillespie, Duncan, Jenny Hatchard, Hazel Squires, Anna Gilmore, and Alan Brennan. 2020. “Archived Data for ‘Conceptualising Changes to Tobacco and Alcohol Policy as Affecting a Single Interlinked System’.” The University of Sheffield.
———. 2021. “Conceptualising Changes to Tobacco and Alcohol Policy as Affecting a Single Interlinked System.” BMC Public Health 21 (1): 17.