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Smoking remains a significant public health issue. A researcher trying to broaden knowledge and understanding of why people are continuing to smoke in the home is Dr Kate Frazer from University College Dublin, Ireland. She is the recipient of two fellowships with the Health Research Board and has recently been awarded the ESRC-IRC UK-Ireland Social Science Networking Award with Dr Rachel O’Donnell from the University of Stirling. Together, they are co-leading a new multidisciplinary network, bringing together researchers, policy partners and community groups to help reduce smoking in the home across the UK and Ireland.

In this post, Kate shares how the HRB and their fellowships have helped transform her research career and tells us about her understanding of smoking behaviour and efforts to help stop smoking. Read the blog post to learn more about the project and why public and patient involvement is playing a pivotal role.

I am a lecturer based at University College Dublin School of Nursing, Midwifery and Health Systems in Ireland. Health Research Board (HRB) funding has helped transform my career and led me to my current position as an independent researcher working with colleagues to support marginalised population groups with a particular focus on reducing secondhand smoke exposure. 

Through HRB fellowships, I began to embed public and patient involvement in my research. I saw how crucial it was to work in partnership with people and patients, to listen to and learn from them to help us understand and co-design solutions and interventions to improve public health.

I have focused my research career around smoking behaviour and have been involved in two systematic reviews for the Tobacco Addiction Group at the University of Oxford. First, investigating the impact of legislative smoking bans on reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. This was followed by examining institutional smoking bans to reduce harms and secondhand smoke exposure, specifically looking at policy level bans in organisations including hospitals, universities and prisons.

Collaborative work to create smoke-free homes

My recent research seeks to understand how we can reduce smoking and secondhand smoke exposure in general and specifically in marginalised populations. I am Principal Investigator of the Smoke-free Homes Innovation Network (SHINE) with Dr Rachel O’Donnell, University of Stirling. SHINE is funded by the Irish Research Council and Economic and Social Research Council (UK), and brings together a multidisciplinary group of academics, researchers, practitioners, and policymakers representing Ireland and the UK. 

We know that smoking rates are reducing in Ireland; however, higher rates persist for those living in deprivation. We want to understand how to support people to create smoke-free homes, with particular interest in the health risks of smoking to pregnant women and children.

Evidence suggests that creating smoke-free homes increases smokers’ likelihood of quitting and should also decrease the chance that children will become smokers themselves. We welcome future Irish legislation which will extend tobacco-free spaces in community settings (GOI 2021 https://www.gov.ie/en/publication/441c8-healthy-ireland-strategic-action-plan-2021-2025/). I will commence PPI activities and link with practitioners and voluntary groups supporting smoke-free activities in the home.

PPI and inclusivity in research

In 2006 I developed and submitted my first PhD research proposal to the HRB without a PPI engagement plan. It was only after commencing the study to develop an education programme for public health nurses, that I sought input from people in primary care who lived with hepatitis C virus. However, in recent years, I’ve learnt there is more to gain when a PPI partnership is initiated at the planning stage, as it enables co-design and establishes a more meaningful collaboration. 

Health Research Board funding supported the development of the PPI Ignite Programme to help support researchers to involve public and patient in their research. The inaugural UCD PPI Ignite scheme was led by Professor Thilo Kroll and Dr Éidín Ní Shé. Critical evidence from their work identified a values-based approach is necessary for PPI engagement. The four values are respect, openness, reciprocity, and flexibility, which should all be considered at the pre-commencement stage. These values should be used to support inclusive, effective and collective PPI across all stages of involvement.

My research now takes a PPI centred approach in which I listen to and learn from people who smoke, in order to help us understand and co-design solutions and interventions using a health systems lens. Working in partnership and tailoring approaches based on feedback is crucial to support smoking cessation strategies, create smoke-free homes, and reduce health inequity.