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In the UK, harm caused by alcohol has worsened since 2020. A recent report from the Institute of Alcohol Studies projecting future rates of major alcohol-related diseases highlights what this means for health and healthcare. The authors argue that this additional burden is not inevitable if effective policies are introduced.

Urban transport infrastructure and motorised road traffic contribute to the physical or psychological separation of neighbourhoods, with possible effects on the health and wellbeing of local residents. This issue, known as "community severance", has been approached by researchers from a range of disciplines, which have different ways of constructing scientific knowledge. The objective of this paper is to build bridges between these different approaches and provide a basis for the integration of the issue into public policy. A framework for cross-disciplinary research on community severance is developed, built on the results of two workshops attended by researchers from different disciplines. This framework takes into consideration the chain of direct and indirect effects of transport infrastructure and motorised traffic on local communities and the complexity in the methods used for analysing and formulating solutions to the problem. The framework is then compared with the views of practitioners, based on discussions held in a third and final workshop. It was concluded that to better understand community severance, researchers should frame their work in relation to that of other disciplines and develop tools that reflect the diversity of local contexts and stakeholders, balancing complexity with applicability.

The links between transport and health are well documented, but the extent of these benefits and disbenefits is not widely understood by non-health professionals. Additionally, there are less obvious, indirect ways in which transport and health are linked. This paper provides a broad overview of the literature, compiling empirical evidence that describes, and where possible quantifies, the health effects of transport planning for the reference of transport professionals. The paper makes the case for considering health alongside the environment when assessing a policy or development′s sustainability, and provides empirical evidence to assist transport professionals in considering benefits or disbenefits involved.

ObjectiveTo use the relation between cigarette consumption and cardiovascular disease to quantify the risk of coronary heart disease and stroke for light smoking (one to five cigarettes/day).DesignSystematic review and meta-analysis.Data sourcesMedline 1946 to May 2015, with manual searches of references.Eligibility criteria for selecting studiesProspective cohort studies with at least 50 events, reporting hazard ratios or relative risks (both hereafter referred to as relative risk) compared with never smokers or age specific incidence in relation to risk of coronary heart disease or stroke.Data extraction/synthesisMOOSE guidelines were followed. For each study, the relative risk was estimated for smoking one, five, or 20 cigarettes per day by using regression modelling between risk and cigarette consumption. Relative risks were adjusted for at least age and often additional confounders. The main measure was the excess relative risk for smoking one cigarette per day (RR1_per_day−1) expressed as a proportion of that for smoking 20 cigarettes per day (RR20_per_day−1), expected to be about 5% assuming a linear relation between risk and consumption (as seen with lung cancer). The relative risks for one, five, and 20 cigarettes per day were also pooled across all studies in a random effects meta-analysis. Separate analyses were done for each combination of sex and disorder.ResultsThe meta-analysis included 55 publications containing 141 cohort studies. Among men, the pooled relative risk for coronary heart disease was 1.48 for smoking one cigarette per day and 2.04 for 20 cigarettes per day, using all studies, but 1.74 and 2.27 among studies in which the relative risk had been adjusted for multiple confounders. Among women, the pooled relative risks were 1.57 and 2.84 for one and 20 cigarettes per day (or 2.19 and 3.95 using relative risks adjusted for multiple factors). Men who smoked one cigarette per day had 46% of the excess relative risk for smoking 20 cigarettes per day (53% using relative risks adjusted for multiple factors), and women had 31% of the excess risk (38% using relative risks adjusted for multiple factors). For stroke, the pooled relative risks for men were 1.25 and 1.64 for smoking one or 20 cigarettes per day (1.30 and 1.56 using relative risks adjusted for multiple factors). In women, the pooled relative risks were 1.31 and 2.16 for smoking one or 20 cigarettes per day (1.46 and 2.42 using relative risks adjusted for multiple factors). The excess risk for stroke associated with one cigarette per day (in relation to 20 cigarettes per day) was 41% for men and 34% for women (or 64% and 36% using relative risks adjusted for multiple factors). Relative risks were generally higher among women than men.ConclusionsSmoking only about one cigarette per day carries a risk of developing coronary heart disease and stroke much greater than expected: around half that for people who smoke 20 per day. No safe level of smoking exists for cardiovascular disease. Smokers should aim to quit instead of cutting down to significantly reduce their risk of these two common major disorders.

Community severance, where transport infrastructure or traffic volume/speed prevents access to goods, services and people, is often mentioned by transport planners but is rarely studied. Severance probably affects travel patterns, social networks, and wellbeing but without measurement tools, this is uncertain. The UCL Street Mobility project is developing a questionnaire to measure community severance and its impacts on individuals in two London case studies.

Motorised traffic inhibits walking, with possible effects on physical exercise, social contacts, and access to services, and ultimately on people’s health and wellbeing. Road traffic may also lead pedestrians to engage in risky behaviours. This paper analyses pedestrian flows and behaviour in relation to the characteristics of roads and traffic in two areas in London. The work is part of the Street Mobility and Network Accessibility project to develop tools to overcome barriers to walking among older people.