Abstract
Background The Smoking and Alcohol Toolkit Study (STS/ATS) in England has delivered timely insights to inform and evaluate strategies aimed at reducing tobacco smoking- and alcohol-related harm. From the end of 2020 until at least 2024 the STS/ATS is expanding to Scotland and Wales to include all constituent nations in Great Britain. Expanding data collection to Scotland and Wales will permit the evaluation of how smoking and alcohol related behaviours respond to divergent policy scenarios across the devolved nations. Methods The STS/ATS consists of monthly cross-sectional household interviews (computer or telephone assisted) of representative samples of adults in Great Britain aged 16+ years. Commencing in October 2020 each month a new sample of approximately 1700 adults in England, 450 adults in Scotland and 300 adults in Wales complete the survey (~n = 29,400 per year). The expansion of the survey to Scotland and Wales has been funded for the collection of at least 48 waves of data across four years. The data collected cover a broad range of smoking and alcohol-related parameters (including but not limited to smoking status, cigarette/nicotine dependence, route to quit smoking, prevalence and frequency of hazardous drinking, attempts and motivation to reduce alcohol consumption, help sought and motives for attempts to reduce alcohol intake) and socio-demographic characteristics (including but not limited to age, gender, region, socio-economic position) and will be reviewed monthly and refined in response to evolving policy needs and public interests. All data analyses will be pre-specified and available on a free online platform. A dedicated website will publish descriptive data on important trends each month. Discussion The Smoking and Alcohol Toolkit Study will provide timely monitoring of smoking and alcohol related behaviours to inform and evaluate national policies across Great Britain.
Highlights
Each year in the devolved nations of Great Britain (England, Scotland and Wales) tobacco smoking and alcohol use together are estimated to cause over 90,000 deaths and more than 1 million hospital admissions[1,2,3]
For data aggregated at the population level, methods of timeseries analysis (TSA) include generalized least squares (GLS), generalized additive mixed models (GAMM), autoregressive integrated moving average with exogenous input (ARIMAX) and vector autoregression (VAR) models
Regular updates will be delivered to key stakeholders across these nations including devolved governments, key public health bodies and non-governmental organisations working in tobacco or alcohol control
Summary
Design The STS/ATS involves monthly cross-sectional household computer-assisted interviews, conducted by Ipsos Mori. Each month a sample of approximately 2,450 adults aged 16+ years and over in Great Britain (1,700 in England, 450 in Scotland, 300 in Wales) is included. Data for the ATS in England were first collected in March 2014. The expansion of STS/ATS data collection to include Scotland and Wales commenced in October 2020. Great Britain is first split into 227,403 ‘Output Areas’, each comprising of approximately 300 households. These areas are stratified according to established geo-demographic characteristics and geographic region randomly selected into an interviewer’s list. Before the COVID-19 crisis, these areas were randomly allocated to interviewers, who travel to their selected areas to conduct electronic interviews with one member of the household aged 16 years or over.
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