New research unit provides evidence to address national addictions policy challenges

Background: The UK faces significant challenges in designing policy to reduce the harm from addiction. While smoking prevalence has fallen, it remains the biggest cause of preventable illness and death and England has the ambition to be smokefree by 2030; alcohol-specific deaths in the UK increased by 25% between 2019 and 2021; just under half of all drug-poisoning deaths are related to opioids; and over half of adults report gambling, many at levels exposing them and others to risk. All these behaviours co-occur with and contribute substantially to wider health inequalities.

Methods: The UK Government funds Policy Research Units (PRUs) in different policy areas to ensure it has the best possible information and evidence available when making policy decisions. From 2024, this includes a 5-year PRU in Addictions (addictive products, behaviours and systems) to provide a long-term resource for policy research and a rapid-response research service for emerging policy needs. The PRU includes experts at seven universities leading workstreams on tobacco, alcohol, drugs, gambling and Patient and Public Involvement and Engagement (PPIE). Strong PPIE structures will ensure meaningful contribution to designing, conducting and disseminating research; training of early career researchers will build capacity.

Results: In collaboration with policymakers, four initial projects addressing key challenges have been initiated. Early career researchers have been recruited.

To achieve a smokefree population, additional efforts for smoking cessation are necessary. The government will provide one million people attempting to stop smoking with a vaping starter kit and behavioural support and separately provide financial incentives for smoking cessation in pregnancy. This will be the first time that such interventions have been implemented nationally in any country and the PRU will evaluate their impact.

For alcohol policy, a common failure to integrate people with alcohol dependence in model-based analyses of the general population hinders the provision of evidence on the potential impact of alcohol policy and interventions. The PRU will develop a roadmap for producing a whole population policy model.

Opioid overdose deaths can be reduced by naloxone if present at the time of overdose; however, carriage rates fall far short of the WHO target. The PRU will develop and test the functionality of key elements for online and other remote provision of overdose training and naloxone carriage.

The greatest population burden of gambling may arise from those not identified by the usual high-risk threshold because of the much larger population gambling at lower risks. The PRU will explore harms from gambling at different levels, both to those gambling and wider society.

Conclusions: This unique cross-addictions unit will create research with direct impact on national policy and develop future addictions researchers. Any results available by October will be shared and discussed.