About us

Fresh and Balance has over 30 years combined experience in working to address the impact of tobacco and alcohol on ill health, harm to communities and fuelling health inequalities.

It’s has been estimated that around half of the burden of disease in England is preventable. Our guiding principle is that if we are to reduce smoking and alcohol consumption, it is vital people are aware of the risks, the impact and can be supported to quit or cut down.

But awareness is not enough. We need action nationally on the pricing, promotion and availability of alcohol and tobacco. We need to approach tobacco and alcohol as commercial determinants of ill health.

This also means limiting the ability of tobacco and alcohol companies to keep people smoking and keep alcohol consumption high, as well as shining a light on their activities in pricing and promoting their products and lobbying activities.


Fresh began in 2005 as the UK’s first comprehensive regional tobacco control programme to address the worst rates of smoking and smoking-related disease in England.

We have worked with local government and the NHS, key national agencies and across our local communities to change our region’s relationship to tobacco and smoking. Since then adult smoking has almost halved from 29% in 2005 to 13.1% in 2022.


Balance launched in 2009 to raise awareness of the risks of alcohol, the harm to society and to call for more action at a national level. Alcohol is too cheap, too available and too heavily promoted and nearly half of adults in our region are drinking at levels which put health at risk.

We follow the evidence around effective population working to address alcohol and tobacco, and gather research to follow the latest data and behavioural insight.

We also stay on top of emerging issues such as vaping and illegal tobacco and the role of the tobacco and alcohol industry.

National partnerships

Fresh and Balance are core members of the Smokefree Action Coalition (SFAC) and the Alcohol Health Alliance (AHA) – two coalitions of leading medical organisations and health charities calling for action nationally.

These include Association of Directors of Public Health, Cancer Research UK, Faculty of Public Health and Royal College of Physicians.

We are also members of Eurocare, Smokefree Partnership and the Global Alliance for Tobacco Control.

The problem

Tobacco and alcohol harm health and limit life chances. But they also affect families and local communities and our public services. They drive poverty and affect businesses and the wider regional economy.

Our vision

Our vision for the North East is a healthier, safer, happier future for all free from tobacco and alcohol-related harm, working in partnership to lead positive social change.


Fresh and Balance is one programme working with many multi-agency partners across health, local government, emergency services and the voluntary sector to address the issues caused by alcohol and tobacco.

The Health Foundation - risk factors for ill health

Read this report from the Health Foundation – a review of government policies tackling smoking, poor diet, physical inactivity and harmful alcohol use in England.