House of Lords - Behaviour Change - Science and Technology Committee

Behaviour Change - Science and Technology Committee Contents

CHAPTER 7: CASE STUDIES

7.1. To assist us in our inquiry, we undertook two case studies. The first looked at government behaviour change interventions to reduce the prevalence of obesity and the second at interventions to reduce car use to limit CO₂ emissions. These policy areas were chosen because they both involve major challenges which require significant changes in behaviour. They differ in that the first policy area is principally concerned with benefiting the individual (though reducing burdens on the health service must also be a concern), the second involves preventing harm to society at large, now and in the future. Where findings from the case studies have been used in the preceding Chapters to inform our more general findings or recommendations, this has been noted in the text. In addition, we have made some more specific recommendations in relation to each case study.

Case Study 1: Tackling obesity

7.2. In 2009, almost a quarter of adults in England were classified as obese and three in 10 children aged between two and 15 were classified as either obese or overweight.[253] Obesity is a major public health problem. It is associated with a number of chronic diseases such as type 2 diabetes and high blood pressure, both major risk factors for cardiovascular disease.[254] A Foresight report ("the Foresight report") on tackling obesity, published in 2007, estimated that, without action, obesity-related diseases would cost society £49.9 billion per year by 2050.[255]

What do we know about how to influence behaviour to reduce obesity?

7.3. The Foresight report concluded that:

The causes of obesity are complex, encompassing biology and behaviour, but set within a cultural, environmental and social framework.
For an increasing number of people obesity is an inevitable—and largely involuntary—consequence of exposure to a modern lifestyle, which has included major changes to work patterns, transport, food production and food sales.
Successfully tackling obesity is a long-term, large-scale commitment.
The obesity epidemic cannot be prevented by individual action alone and requires a societal approach.
Preventing obesity is a societal challenge, similar to climate change. It requires partnership between government, science, business and civil society.[256]

7.4. Witnesses who gave evidence to us agreed that the behaviours which lead to obesity are a consequence of a number of interacting influences working at various levels (the individual, family and organisation) and involving social and environmental factors.[257] As in the Foresight report, some suggested that the environmental determinants of behaviour were particularly important and that, arguably, the current societal environment was one in which unhealthy choices were easier than healthy choices (sometimes described as the "obesogenic environment").[258] Professor Baldwin said, for example, that:

259

Because behaviour is influenced at many levels, several witnesses commented that a range of interventions would need to be applied simultaneously to be effective.[260]

7.5. The link between health inequalities and obesity was also highlighted by some witnesses,[261] a connection well-documented in the recent Marmot review.[262] Professor Michie argued that this suggested that interventions should be targeted at particular groups: "NICE's review of behaviour change ... has demonstrated, and been supported by lots of evidence since, that interventions that are tailored towards the targeted population tend to be more effective than those that aren't".[263] We note the commitment by DH to take steps to reduce health inequalities, particularly through early intervention and prevention, and look forward to seeing how this will be translated in their forthcoming obesity strategy.

GAPS IN THE EVIDENCE-BASE

7.6. According to the Association for the Study of Obesity and NICE, the evidence relating to effective behaviour change interventions and obesity at the level of the individual and small groups was clear (and reflected in NICE guidance).[264] But, as with other policy areas, there are significant gaps in the applied research base at the population level. Dr Melvyn Hillsdon, University of Exeter, for example, said:

265

Are Government obesity policies evidence-based?

7.7. Bearing in mind what is known about behaviour change interventions and reducing obesity, we have considered the extent to which the Government's obesity policies are evidence-based. We are aware that our assessment is in advance of the publication of the Government's obesity strategy, which is due shortly.

THE "OBESOGENIC ENVIRONMENT"

7.8. Several witnesses acknowledged that, following the Foresight report, DH had made efforts to pursue an evidence-based approach to obesity,[266] but they were critical of DH on the ground that insufficient attention was being paid to tackling the wider environment in which decisions are made.[267] Dr Campbell, for example, commented that "confronting the real commercial and environmental stimuli of obesity has not yet been achieved".[268] The current Government have stated that, though they want to assist individuals in taking responsibility for their own health, their obesity strategy will involve changes to the wider environment to make it easier for people to adopt a healthier diet and increase their physical activity.[269]

Change4Life

7.9. Change4Life began in January 2009 and is currently described as the marketing component of the Government's response to the rise in obesity.[270] According to DH, the campaign aims to inspire a societal movement in which everyone who has an interest in preventing obesity, including government, business, healthcare professionals, charities, schools, families or individuals, can play their part (see Box 8, page 37).

7.10. Several witnesses commented positively about the extent to which the Change4Life programme was evidence-based.[271] The Sustainable Development Commission, for example, said that the programme made good use of messengers and provided a good example of how to integrate behavioural sciences into the design of an intervention.[272] Tim Duffy of M&C Saatchi referred to the precise segmentation work undertaken by DH in order to target interventions more accurately. DH itself described to us how piloting was used: the Change4Life convenience stores project was piloted in the North East, after which, given the results of the pilot, the intervention it was rolled out more widely.[273]

7.11. The Change4Life campaign—in particular the Great Swapathon initiative—has, however, not been without criticism. The Great Swapathon provided vouchers to families for discounted food products and activities. But far from encouraging healthy eating, some evidence suggested that providing discounted healthy products actually encouraged people to buy more unhealthy ones.[274] Furthermore, although Sian Jarvis, Director General of Communications at DH, said that there had been some analysis of the extent to which the Change4Life programme has influenced purchasing behaviour (and that the results were positive)[275], much of the evaluation so far has taken the form of an assessment of brand recognition and claimed change[276]—a worrying example of the lack of outcome measures associated with a behaviour change intervention which we describe in paragraph 6.7 above.

7.12. It appears that the Change4Life programme has, on the whole, been evidence-based and appropriately targeted. We note the Government's commitment to continue using the brand and urge DH to ensure that future evaluations are robust and establish whether or not the programme is likely to be successful in the longer term.

Population wide interventions: advertising, marketing and food labelling

7.13. Restrictions on advertising during children's programmes of products high in fat, salt and sugar were introduced by Ofcom in 2007. In June 2010, a NICE report (on preventing cardiovascular disease) recommended that these regulations should be extended on the ground that programmes for older audiences also had a powerful influence on young people.[277] Several witnesses commented on the impact of food marketing and advertising on food purchasing and eating behaviour, particularly on children,[278] noting that tackling food advertising was particularly cost effective because of its low cost and broad reach. Evidence about the impact of wider marketing activities, such as in-store marketing and product promotions, appears to be limited, though Professor Marteau suggested that there is a growing body of evidence that product packaging has an impact on food choice. Furthermore, there is evidence to suggest that television advertising can have a long-term impact on eating behaviour beyond consumption of the product being advertised.[279] In January 2010, DH commissioned an independent review of the regulatory and non-regulatory framework for marketing and promotion of food and drink to children. We await its findings, expected to be published shortly, with interest.[280]

7.14. In relation to food labelling, Anne Milton MP, Parliamentary Under Secretary of State at the DH, said that there was "a huge amount of conflicting evidence".[281] We do not think this is a fair summary. Although some witnesses argued that the impact of food labelling on purchasing and eating behaviour had yet to be established[282], all witnesses who were asked, with the exception of those from DH, agreed that the evidence demonstrated that those labels which included traffic light colours were better understood by consumers than those without.[283] Professor Marteau said, for example: "the evidence shows that people certainly understand ... more clearly ... the nutritional content of the food when traffic light labels are used, compared to a more numerical system" (although, she went on, "what we don't know very well is the impact of that knowledge on ... purchasing and ... consumption".)[284] A 2009 study by the Food Standards Agency concluded that the labels which achieved the highest levels of comprehension among consumers were: first, a label combining text (the words high, medium and low) and traffic light colours (71%) and, second, a label combining text, traffic light colours and percentage of guideline daily amount (GDA) (70%).[285] According to NICE, front of packaging traffic light labelling helped consumers make more informed choices about food consumption and, as a result, they recommended strongly the introduction of a single, integrated traffic light colour-coded system of food labelling as the national standard.[286]

7.15. Some witnesses asserted that there was not only a connection between traffic light labelling and comprehension, but also between traffic light labelling and behaviour. Asda and Sainsbury's both said they used this labelling on their own-brand products and both provided evidence that the introduction of traffic light labelling led to a decrease in sales of those products with red on the label.[287] Mr King told us, for example, that:

288

7.16. Despite this evidence, the Government have decided to pursue a system of labelling based on percentage GDA. Ms Milton justified this decision on the basis that they were trying to achieve a system that was "consistent" and "meaningful", and "relevant to all the groups" that they were "trying to target".[289] Officials from DH gave a similar account. They said that the decision was based on evidence that a consistent approach was most likely to be effective, and that they did "not believe that traffic lights would have been consistently adopted by the food industry".[290] This suggests to us that the Government's policy on food labelling was determined not by the evidence but by what could be achieved through voluntary agreement with the food industry.

7.17. We invite the Government to explain why their policy on food labelling and marketing of unhealthy products to children is not in accordance with the available evidence about changing behaviour. Given the evidence, we recommend that the Government take steps to implement a traffic light system of nutritional labelling on all food packaging. We further recommend that the Government reconsider current regulation of advertising and marketing of food products to children, taking a more realistic view of the range of programmes that children watch.

Partnership working and voluntary agreements

7.18. The Foresight report favoured tackling obesity through a partnership between government, science, business and civil society. In Chapter 5 we suggested that Change4Life is a positive example of partnership working (see Box 8, page 37). DH is also pursuing voluntary agreements with businesses as part of their attempt to change the environment through the Public Health Responsibility Deal (see Box 10, page 39). The first agreements under the food network of the Deal were published in March 2011. The only pledge relating to obesity is:

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The Government's principles for calorie labelling are that calorie information should be: displayed clearly and prominently at point of choice; provided for standardised food and drink items sold; provided per portion, item or meal; and, displayed in a way that is appropriate for the consumer.[292]

7.19. In Chapter 5, we noted that the pledges made by the alcohol network were criticised by a number of health organisations (see Box 10, page 39). The pledge made by the food network is more specific than those made by the alcohol network and gives a defined time period for its completion. DH has not, however, specified the outcome measures which it will use to establish whether or not this pledge has had an impact on purchasing and eating behaviour, and when and on what basis they will make a decision on whether it should pursue alternative action to change behaviour. Moreover, this pledge does not reflect the evidence about the need to make substantial changes to the environment in order to tackle obesity at a population level, or the evidence that traffic light labels are the most effective form of labelling (see paragraphs 7.14-7.17 above).

Conclusion

7.20. We draw attention to our recommendation in paragraph 5.27 about the failures of all current pledges made by the Public Health Responsibility Deal. Moreover, obesity is a significant and urgent societal problem and the current Public Health Responsibility Deal pledge on obesity is not a proportionate response to the scale of the problem. If the Government intend to continue to use agreements with businesses as a way of changing the population's behaviour, we urge them to ensure that these are based on the best available evidence about the most effective measures to tackle obesity at a population level. In particular, they should consider the ways in which businesses themselves influence the behaviour of the population in unhealthy ways. If effective measures cannot be achieved through agreement, the Government must pursue them through other means.

WEIGHT MANAGEMENT INTERVENTIONS

7.21. Although there is evidence about how to change behaviour when interventions are targeted at individuals (for example through commercially provided weight loss programmes which encourage changes to diet and physical activity behaviour),[293] some witnesses suggested that, at present, many weight management interventions are poorly evaluated. As a result, there is a lack of understanding about how these interventions affect behaviour, particularly in the long term.[294]

7.22. The Health Trainers programme allows clients to select goals and the majority choose to pursue changes in eating and physical activity. The design of this intervention was informed by health psychologists from the BPS working within DH under the previous Government. Health Trainers' practice is based on the Health Trainer Handbook developed by health psychologists on the basis of evidence of effective techniques for changing behaviour, including motivational interviewing, specific goal setting, self-monitoring, feedback and goal review. These techniques are directed towards enhancement of individual motivation and self-efficacy for change. The importance of these principles is identified in 2007 NICE guidance on behaviour change based on a review of available evidence.

7.23. The programme is also designed to reduce health inequalities, by targeting those in lower socio-economic groups and ethnic minorities.[295] The Health Trainers intervention is an example of effective collaboration between policy makers and experts leading to the development of evidence-based policies. There have however been problems with evaluation of the programme, particularly because of a lack of adequate controls as a result of insufficient funding and the poor quality data collected in local areas (see Box 15, page 49).

7.24. Problems with the evaluation of the Health Trainers programme reflect wider concerns about a lack of evidence-based commissioning and proper evaluation of weight management interventions at the local level (see paragraph 5.32 above). The National Obesity Observatory has developed a Standard Evaluation Framework for weight management interventions in order to support high quality evaluation.[296] The extent to which this is used is however unclear.[297]

Conclusion

7.25. Given these concerns about evidence-based commissioning and evaluation, we recommend that DH should commission a review of the provision of weight management services, including the Health Trainers programme, across the country. We recommend further that NICE should compile a list of approved weight management services which adhere to their best practice guidance. If the Health Trainers programme is included in this list, we recommend that the Government should continue the programme, particularly in the light of its focus on tackling health inequalities.

Case Study 2: reducing car use

7.26. Greenhouse gas emissions from transport represent 21% of the total United Kingdom domestic emissions. Emissions from private car use constitute 78% of that figure, representing 17% of total emissions or 91.5 million tonnes of CO₂ in 2008. Although technological measures are important in reducing emissions, it is argued they are unlikely to be sufficient to achieve the necessary reduction in carbon emissions in the short term.[298] A significant reduction in car use is also needed.

What does the evidence say about how to reduce car use?

7.27. An individual's choice of transport mode is influenced by a number of factors. Social norms, habitual and automatic behaviour and public transport infrastructure have been identified as particularly important. For many drivers, it appears that environmental awareness is not an important factor, although people can be motivated to change their driving habits because of the health benefits of walking and cycling.[299] Changing choice of transport mode is likely to require a range of interventions, including interventions to change individual behaviour or attitudes, interventions to change the environment, and regulatory and fiscal measures.[300] Dr David Metz, former CSA at the DfT, observed with regard to the latter that without such 'upstream' regulatory and fiscal disincentives, a reduction in car use by some will tend to be offset by others taking advantage of reduced congestion.[301]

7.28. Many witnesses observed that "mode choice" was not the only factor in reducing car use. Professor Goodwin noted, for example, that little over a quarter of the decline in car use over the past decade could be accounted for by individuals using different modes of transport, the remainder was as a result of shortening journey distances and fewer journeys being undertaken.[302] Other witnesses cited the increased use of telecommunications and changing commuting patterns as significant factors.[303]

FISCAL MEASURES AND DISINCENTIVES TO CAR USE

7.29. Many witnesses argued that policies that provide a direct disincentive to car use were most effective, if accompanied by improvements to alternative transport services. Successful examples of this included parking controls and road user charges,[304] and vehicle ownership taxes and fuel duties. While the latter are likely to be an effective intervention, it was acknowledged that they might fall disproportionately on rural drivers.[305] Examples of effective non-fiscal disincentives included measures to reduce road capacity and to calm traffic, and pedestrianisation of city centres.[306] There is substantial evidence about the impact of the latter from European cities.[307]

INFRASTRUCTURE

7.30. Some witnesses argued that "urban form", where the physical environment is designed to suit lifestyles, has developed around roads and cars in the United Kingdom. This creates a strong lock-in to cars as the primary form of personal transport and the car is seen by many as more convenient than other modes of transport.[308] While infrastructural changes alone may not be sufficient to change behaviour,[309] they are an effective and often necessary component of a package of interventions. This view is supported by the results of the DfT Sustainable Travel Towns pilots (see Box 18, page 64) which showed that there was a correlation between increases in cycling and bus use and investment in infrastructure, and that marketing and promotion without changes to infrastructure had little effect.[310]

7.31. Changes to infrastructure have to be appropriately targeted to the people, places and journeys which are most susceptive to influence.[311] The Cycling Demonstration Town programme, for example, suggested that infrastructure improvement was best focused on main routes to important destinations such as schools, workplaces and shopping centres.[312]

INFORMATION PROVISION

7.32. Whilst information provision in isolation may have limited effect,[313] evidence suggests that large-scale education campaigns, together with other measures such as fiscal interventions and improvements to infrastructure, can be effective in changing behaviour.[314] The DfT agreed that behaviour change usually requires a package of interventions of which the provision and presentation of information is one aspect.[315] The provision of information and personalised travel planning were features of the Sustainable Travel Towns pilots and, according to some witnesses, they had a high impact and were cost-effective.[316]

STRENGTHS AND WEAKNESSES OF THE EVIDENCE-BASE

7.33. A number of witnesses suggested that there now exists an extensive and well-researched evidence-base in the area of mode choice, in contrast to other policy areas, and that lack of knowledge and experience are not the main barrier to successful initiatives to change behaviour.[317] The UKCRC Centre for Diet and Activity Research Centre suggested, however, that there is limited evidence from well-designed studies to indicate the most effective interventions to change travel mode share in the population. This reflects the point made above that there is a lack of applied research at a population level. This did not, they said, mean that there were no effective interventions but rather that approaches which showed promise should be developed further and more rigorously evaluated.[318]

7.34. Some witnesses identified, in particular, a lack of evidence about how to reduce car use for medium-length trips. This is an important gap in the evidence-base, as figures suggest that trips of less than 10 miles only contribute 36% of carbon emissions from cars, while trips of more than 10 miles account for 64%.[319] Transport for Quality of Life agreed that interventions intended to reduce carbon emissions should focus on medium and longer trips.[320] We recommend that the DfT should prioritise funding to research the most effective behaviour change interventions to reduce car use for medium and longer-length journeys and undertake pilots of those interventions as soon as possible.

Are the Government's policies based on the evidence?

7.35. The Government's approach to changing travel behaviour was outlined in the Creating Growth, Cutting Carbon white paper published in January 2011. Key elements are:

promoting and enabling choice rather than restricting choice;
integrated policy packages;
promoting alternatives to travel (see paragraph 7.28); and
the localism agenda (the Sustainable Transport Fund).

PROMOTING AND ENABLING CHOICE

7.36. The DfT focus on promoting and enabling choice is consistent with the Government's more general approach in favour of non-regulatory and non-fiscal measures (see paragraphs 5.2-5.15 above). As a result, the Government's sustainable transport policy is marked by an absence of significant fiscal and regulatory disincentives to change behaviour. But, as we have said (in paragraph 7.29), the evidence indicates that strong disincentives, many of which are likely to be financial, are a key element in changing travel-mode choices. Bearing in mind our concern (see paragraph 5.14 above) that the Government's preference for non-regulatory interventions may lead officials to give insufficient consideration to regulatory and fiscal interventions, we urge the DfT to ensure that evidence for both non-regulatory and regulatory measures is taken into account when formulating policies to reduce car use.

7.37. An emphasis on promoting and enabling choice also confirms the importance of having an infrastructure which provides a broader range of cheap and efficient public transport services. We were told that European cities with low levels of car use have consistently spent far more per person on infrastructure. Cycling England said in relation to cycling, for example: "levels of expenditure on cycling in successful European towns and cities ... were at least £10 per head of population per year. By contrast, analysis of Local Transport Plan outturn expenditure data for English local authorities, carried out at our request by the Department for Transport, demonstrated that the average level of spend by English local authorities was less than £1 per head of population per year".[321] In our seminar on reducing car use, it was noted that spend per person in Copenhagen was around £40 per head of population per year.[322]

7.38. The Sustainable Transport Fund (see paragraphs 7.44-7.46) will provide for improvements to infrastructure in a local context, though, we were told, it would "not support major rail, passenger transport or road infrastructure enhancements, which would be more appropriately funded from other sources".[323] Ms Sloman of Transport for Quality of Life highlighted concerns that:

324

But in response, Mr Dowie said that the DfT "still have ... a very substantial local capital programme".[325] As the evidence suggests that good infrastructure is a prerequisite for, and greatly enhances, the effectiveness of other "smarter choices" measures, we strongly encourage the DfT to ensure that, wherever possible in a time of financial stringency, a sufficient proportion of funds is maintained to make effective improvements and changes to infrastructure.

INTEGRATED POLICY PACKAGES

7.39. The DfT has embraced the use of integrated policy packages as part of its promoting and enabling choice agenda. The Sustainable Travel Towns (STT) initiative (see Box 18, page 64) and the Cycling Cities and Towns programme (see Box 19, page 65) are evidence of the department's commitment to using a whole range of "smarter choices" (see Box 17, page 63) initiatives together with small-scale infrastructure change.

7.40. A number of witnesses welcomed this emphasis on encouraging "smarter choices" within a package of interventions that included other harder measures and the provision of infrastructure, noting that packages are more cost-effective. Ms Sloman said, for example, that "it is by combining the better infrastructure, the better services and the encouragement for people to use those that you get more bang for your buck. You achieve more change for each pound you spend because you are not just improving the service, you are telling people about it".[326] Simon Houldsworth, Transport Policy Manager for Darlington, agreed that "without the package you will not get the benefits or the value for money that travel behaviour delivers".[327]

7.41. Whilst we welcome the DfT's emphasis on the use of policy packages, we note they do not include regulatory and fiscal measures and so do not wholly reflect the evidence about how to change transport mode choice. This suggests that their effectiveness and, in turn, their cost-effectiveness could well be limited.

BOX 17

"Smarter Choices"

The term "smarter choices" was used by most witnesses in relation to interventions to change travel behaviour. This term originated with the 2004 DfT report, Smarter choices: changing the way we travel.[328]

There was disparity across the evidence we received about what sorts of interventions should be classified as "smarter choices". Some witnesses told us that "smarter choices" interventions comprise both "soft" measures, such as personal travel planning and local transport marketing, and "hard" measures, such as improvements to infrastructure and pedestrianisation.[329] Others excluded "hard" measures from their descriptions, equating "smarter choices" only with "soft measures".[330] The 2004 report on smarter choices suggests the latter definition—"soft measures"—is more accurate. The 2004 report describes itself as exploring the impact of soft factor interventions and does not address improvements to infrastructure or pedestrianisation. The DfT appear to use this term to describe any intervention that does not make use of regulation or fiscal policy.

Dr Anable, Centre for Transport Research, University of Aberdeen, was clear that "smarter choices" should not be understood as synonymous with "nudges". She noted that "smarter choices" could include nudges but were also about changing social practices and a new approach to policy formulation.[331]

LOCALISM AND THE SUSTAINABLE TRANSPORT FUND

7.42. Several witnesses agreed that local authorities were well placed to implement effective interventions to change travel behaviour because they were responsible for local transport infrastructure.[332] Some, however, sounded a note of caution, on the ground that not all local authorities had the necessary range of professional skills and resources to research and interpret the evidence about how to change behaviour (see paragraph 5.31 above).[333] Transport for Quality of Life, for example, said that it was common for "smarter choices" or other behaviour change teams to be employed on short-term contracts in local authorities. This has prevented local authorities from building up the necessary expertise.[334]

7.43. A similar point was made in relation to a lack of skills within local authorities to evaluate interventions properly.[335] Mr Dowie told us that the DfT was not expecting local authorities to have these skills and that the department had a responsibility to ensure that an evaluation framework was in place. To that end they have published evaluation guidance for sustainable transport interventions (see paragraph 5.33 above).[336] We note however that the Sustainable Transport white paper states that local authorities themselves will be responsible for sharing what works and developing a framework to improve capability at the local level (see paragraph 5.34 above).

BOX 18

The Sustainable Travel Towns initiative

The STT initiative ran between 2004 and 2009 in Darlington, Peterborough and Worcester. The pilots were designed to explore the effectiveness of "smarter choices" measures, therefore excluding fiscal or regulatory measures. Each of the towns employed multi-faceted packages of interventions incorporating a range of non-regulatory and non-fiscal measures, such as:

The provision of infrastructure: on a modest scale and with a focus on cycling and pedestrians.
The provision of new services, such as car sharing schemes, car clubs and community transport services.
The provision of education and propaganda.
Emphasis on community involvement.
The engagement of individuals through consultation exercises, competitions, newsletters and feedback.[337]

This package of measures achieved a reduction in the number of car driver trips by 9% and car driver distance by 5-7%,[338] though witnesses raised some concerns about its evaluation (see paragraph 6.5 above).

7.44. The local sustainable transport fund is the successor to the STT pilots (see Box 18, page 64). The fund will make £560 million available over four years for "smarter choices" local sustainable travel interventions. The DfT describes the purpose of the fund as giving "local transport authorities the opportunity, working in partnership with their communities, to identify the right solutions that meet the particular challenges faced in their areas and deliver the greatest benefits for their communities".[339]

7.45. The department has developed an Enabling Behaviour Change Information Pack for bidders to the Sustainable Transport Fund. The Pack sets out the evidence about effective interventions from Cycling Cities and Towns and the STT pilots. It is intended to help those who bid for funding to base their bids on the available evidence about what works.[340] Whilst we acknowledge that this is a useful development, we note that the guidance simply lists the interventions and does not provide analysis of their effectiveness or contain very much about the use of fiscal measures and other disincentives to car use. Though we recognise that some disincentives to reduce car use would need to be implemented centrally (such as changes to fuel pricing policy), there are still others that are available to local authorities (such as increased parking charges, pedestrianisation and road user charges) and it will be particularly important that central government provides direction in relation to such disincentives in the light of the suggestion from some witnesses that local authorities are reluctant to implement these measures for fear of competition from other cities and lost revenue.[341]

BOX 19

Cycling Cities and Towns

The Cycling Cities and Towns programme has built on the first six cycling demonstration towns. The demonstration towns used multi-faceted packages of interventions to increase cycling, including "new cycle infrastructure; Bikeability cycle training; intensive programmes targeted at schools and workplaces; initiatives to remove barriers to cycling by providing equipment, building skills and increasing confidence; and awareness-raising campaigns under strong brands".[342] These towns saw an average increase in cycling of 27%. The Cycling Cities and Towns programme is based on the evidence of effectiveness of interventions in the demonstration towns.

7.46. Although we welcome the principle of DfT's Local Sustainable Transport Fund, the initiative is based on a pilot project which was incompletely evaluated and so did not provide evidence about the long-term effectiveness of interventions. Furthermore, as we have noted in paragraph 7.41, the Sustainable Travel Towns pilot did not wholly reflect the evidence about how to change transport mode choice.

7.47. We commend DfT's recognition that, if responsibility for interventions is to be devolved to local agents, guidance to commissioners on the evidence and an evaluation framework are necessary. We note, however, that current guidance does not take into account the evidence about the need for strong disincentives to car use needed to achieve significant changes in behaviour and fails to provide any analysis of the evidence associated with effective interventions.

7.48. We are not clear about the extent to which Government intend to reduce carbon emissions by reducing car use but, if they hope to achieve a significant reduction, the evidence suggests that regulatory and fiscal disincentives to car use will be required. We recommend that the Government (a) establish and publish targets for a reduction in carbon emissions as a result of a reduction in car use; (b) publish an estimate of the percentage reduction in emissions which will be achieved through reducing car use and the timescale for its achievement; and (c) set out details of the steps they will take if this percentage reduction is not achieved by this time.

253 Statistics on obesity, physical activity and diet: England 2010, NHS Health and Social Care Information Centre (2010). Back

254 Ibid. Back

255 Tackling obesity: future choices, Foresight and BIS (2007). Back

256 Ibid. Back

257 BC 19, BC 30, BC 32, BC 33, BC 42, BC 48, BC 50, BC 52, BC 56, BC 64, BC 90, BC 99, BC 105. Back

258 BC 19, BC 33, BC 53, BC 64, BC 105. Back

259 BC 66. Back

260 BC 44, BC 52, BC 94, BC 105. Back

261 BC 90. Back

262 Fair Society, Healthy Lives, the Marmot Review (2010). Back

263 Q 103. Back

264 BC 44, BC 52. Back