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Promoting walking and cycling as an alternative to using cars: systematic review

BMJ 2004; 329 doi: (Published 30 September 2004) Cite this as: BMJ 2004;329:763
  1. David Ogilvie, MRC fellow (d.ogilvie{at},
  2. Matt Egan, social scientist1,
  3. Val Hamilton, research coordinator2,
  4. Mark Petticrew, associate director1
  1. 1 MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow G12 8RZ
  2. 2 Centre for Digital Library Research, University of Strathclyde, Glasgow G1 1XH
  1. Correspondence to: D Ogilvie
  • Accepted 4 August 2004


Objectives To assess what interventions are effective in promoting a population shift from using cars towards walking and cycling and to assess the health effects of such interventions.

Data sources Published and unpublished reports in any language identified from electronic databases, bibliographies, websites, and reference lists.

Review methods Systematic search and appraisal to identify experimental or observational studies with a prospective or controlled retrospective design that evaluated any intervention applied to an urban population or area by measuring outcomes in members of the local population.

Results 22 studies met the inclusion criteria. We found some evidence that targeted behaviour change programmes can change the behaviour of motivated subgroups, resulting (in the largest study) in a shift of around 5% of all trips at a population level. Single studies of commuter subsidies and a new railway station also showed positive effects. The balance of best available evidence about publicity campaigns, engineering measures, and other interventions suggests that they have not been effective. Participants in trials of active commuting experienced short term improvements in certain measures of health and fitness, but we found no good evidence on effects on health of any effective intervention at population level.

Conclusions The best available evidence of effectiveness in promoting a modal shift is for targeted behaviour change programmes, but the social distribution of their effects is unclear and some other types of intervention have yet to be rigorously evaluated.


  • Embedded Image Details of the search strategy and study selection, references to primary studies included in the review (w1-w51), five tables of study data, and a flow chart can be found on

    We are grateful to the numerous colleagues who commented on draft versions of our review protocol and reference list. We also thank David Cumming for advice on literature searching and those who provided clarifications and additional information about studies, particularly Solveig Meland, James Ryle, and Julie Whitehouse.

  • Contributors DO and MP had the original idea. DO designed the review with input from MP, carried out study selection, data extraction, and critical appraisal and wrote the paper. All authors contributed to the design of the study and writing of the paper. VH and DO executed the literature search, and ME and MP contributed to study selection, data extraction, and critical appraisal. DO is guarantor for the paper.

  • Funding Chief Scientist Office of the Scottish Executive Health Department and the ESRC Evidence Network.

  • Competing interests None declared.

  • Ethical approval Not required.

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