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Delile JM. Tabac et précarité : l’enjeu central de l’accès aux soins. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:69-80. [PMID: 38423965 DOI: 10.3917/spub.pr1.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The prevalence and severity of smoking are particularly high in populations in precarious situations and make smoking an essential determinant of social inequalities in health, due to its particularly catastrophic impact on the health of these populations. The general reduction in smoking, less significant in disadvantaged populations, contributes to further increasing these inequalities, and smoking tends to be concentrated in the most vulnerable populations. The relationships between tobacco and precariousness are examined by identifying, based on a review of the literature, the main common factors of vulnerability: stress and social adversity, self-stigma, a low feeling of self-efficacy, the social function of tobacco use, the ambivalence of demands, associated addictions, the severity of tobacco dependence, distance from support and care systems, etc. Specific attention is paid to certain particular conditions: mental health disorders, addictions (other than tobacco), inadequate housing, detention, migration. On this basis, courses of action are proposed to improve access to care and its effectiveness for the people concerned. Emphasis is placed on the mobilization of professionals who often tend to neglect issues of smoking in view of the immediate severity of the problems at the origin of the demands of the people received. A support offer for harm reduction (vaping in particular) seems particularly suited to often-ambivalent demands. The importance of networking and the involvement of CSAPAs/CAARUDs is also underlined. At the systemic level, all of this must be accompanied by political advocacy to reduce these inequalities and social determinants of health..
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Merone L, Ashton S, Harris A, Edwards WS, Preston-Thomas A, Gair R, Russell DB. A complex increase in hepatitis C virus in a correctional facility: bumps in the road. Aust N Z J Public Health 2022; 46:377-381. [PMID: 35435996 DOI: 10.1111/1753-6405.13238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 10/01/2021] [Accepted: 02/01/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The prevalence of hepatitis C virus (HCV) in correctional facilities in Australia among people who inject drugs is 60%, with disproportionate effects observed in Aboriginal and Torres Strait Islander people. Following the micro-elimination of HCV in a Queensland correctional facility (QCF), newly acquired cases began to increase in mid-2019. Here we discuss the public health response to increasing HCV in a QCF. METHODS Enhanced surveillance was performed to obtain contextual outbreak data on risk factors including injecting drug use, sharing of personal hygiene equipment and do-it-yourself-tattooing. RESULTS In the sixteen months, there were 250 notifications of new and re-infected HCV infections in prisoners in the QCF. Qualitative data revealed the leading factor in transmission to be injecting drug use. CONCLUSIONS Drivers for increased HCV transmission in correctional facilities include boredom, waiting lists for opioid substitution programs, changes in injecting behaviours and sharing of injecting paraphernalia. Point-of-care testing combined with education and the development of a needle and syringe program may be promising ways forward for managing HCV in correctional facilities. IMPLICATIONS FOR PUBLIC HEALTH Correctional facilities are key locations to target sexually transmitted infection (STI) and blood-borne virus (BBV) testing and treatment as well as health promotion to improve the health of inmates and the communities they return to.
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Affiliation(s)
- Lea Merone
- Tropical Public Health Services, Cairns, Queensland
| | - Sian Ashton
- Tropical Public Health Services, Cairns, Queensland.,College of Health Care Sciences, James Cook University, Queensland
| | - Andy Harris
- Cairns and Hinterland Hospital and Health Service, Queensland
| | | | | | - Richard Gair
- Tropical Public Health Services, Cairns, Queensland
| | - Darren B Russell
- College of Health Care Sciences, James Cook University, Queensland.,Cairns Sexual Health Service, Queensland
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Hunt K, Brown A, Eadie D, McMeekin N, Boyd K, Bauld L, Conaglen P, Craig P, Demou E, Leyland A, Pell J, Purves R, Tweed E, Byrne T, Dobson R, Graham L, Mitchell D, O’Donnell R, Sweeting H, Semple S. Process and impact of implementing a smoke-free policy in prisons in Scotland: TIPs mixed-methods study. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/wglf1204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background
Prisons had partial exemption from the UK’s 2006/7 smoking bans in enclosed public spaces. They became one of the few workplaces with continuing exposure to second-hand smoke, given the high levels of smoking among people in custody. Despite the introduction of smoke-free prisons elsewhere, evaluations of such ‘bans’ have been very limited to date.
Objective
The objective was to provide evidence on the process and impact of implementing a smoke-free policy across a national prison service.
Design
The Tobacco in Prisons study was a three-phase, multimethod study exploring the periods before policy formulation (phase 1: pre announcement), during preparation for implementation (phase 2: preparatory) and after implementation (phase 3: post implementation).
Setting
The study was set in Scotland’s prisons.
Participants
Participants were people in custody, prison staff and providers/users of prison smoking cessation services.
Intervention
Comprehensive smoke-free prison rules were implemented across all of Scotland’s prisons in November 2018.
Main outcome measures
The main outcome measures were second-hand smoke levels, health outcomes and perspectives/experiences, including facilitators of successful transitions to smoke-free prisons.
Data sources
The study utilised cross-sectional surveys of staff (total, n = 3522) and people in custody (total, n = 5956) in each phase; focus groups and/or one-to-one interviews with staff (n = 237 across 34 focus groups; n = 38 interviews), people in custody (n = 62 interviews), providers (n = 103 interviews) and users (n = 45 interviews) of prison smoking cessation services and stakeholders elsewhere (n = 19); measurements of second-hand smoke exposure (e.g. 369,208 minutes of static measures in residential areas at three time points); and routinely collected data (e.g. medications dispensed, inpatient/outpatient visits).
Results
Measures of second-hand smoke were substantially (≈ 90%) reduced post implementation, compared with baseline, largely confirming the views of staff and people in custody that illicit smoking is not a major issue post ban. Several factors that contributed to the successful implementation of the smoke-free policy, now accepted as the ‘new normal’, were identified. E-cigarette use has become common, was recognised (by both staff and people in custody) to have facilitated the transition and raises new issues in prisons. The health economic analysis (lifetime model) demonstrated that costs were lower and the number of quality-adjusted life-years was larger for people in custody and staff in the ‘with smoke-free’ policy period than in the ‘without’ policy period, confirming cost-effectiveness against a £20,000 willingness-to-pay threshold.
Limitations
The ability to triangulate between different data sources mitigated limitations with constituent data sets.
Conclusions
To our knowledge, this is the first study internationally to analyse the views of prison staff and people in custody; objective measurements of second-hand smoke exposure and routine health and other outcomes before, during and after the implementation of a smoke-free prison policy; and to assess cost-effectiveness. The results are relevant to jurisdictions considering similar legislation, whether or not e-cigarettes are permitted. The study provides a model for partnership working and, as a multidimensional study of a national prison system, adds to a previously sparse evidence base internationally.
Future work
Priorities are to understand how to support people in custody in remaining smoke free after release from prison, and whether or not interventions can extend benefits to their families; to evaluate new guidance supporting people wishing to reduce or quit vaping; and to understand how prison vaping practices/cultures may strengthen or weaken long-term reductions in smoking.
Study registration
This study is registered as Research Registry 4802.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 1. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Ashley Brown
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Douglas Eadie
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Nicola McMeekin
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kathleen Boyd
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Linda Bauld
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Philip Conaglen
- Department of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alastair Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jill Pell
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Richard Purves
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Emily Tweed
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Tom Byrne
- Public Health Scotland, Edinburgh, UK
| | - Ruaraidh Dobson
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | | | - Danielle Mitchell
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Rachel O’Donnell
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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Bowe A, Marron L, Devlin J, Kavanagh P. An Evaluation of the Impact of a Multicomponent Stop Smoking Intervention in an Irish Prison. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211981. [PMID: 34831737 PMCID: PMC8624287 DOI: 10.3390/ijerph182211981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 11/29/2022]
Abstract
The disproportionately high prevalence of tobacco use among prisoners remains an important public health issue. While Ireland has well-established legislative bans on smoking in public places, these do not apply in prisons. This study evaluates a multi-component tobacco control intervention in a medium security prison for adult males in Ireland. A stop-smoking intervention, targeting staff and prisoners, was designed, implemented, and evaluated with a before-and-after study. Analysis was conducted using McNemar’s test for paired binary data, Wilcoxon signed rank test for ordinal data, and paired T-tests for continuous normal data. Pre-intervention, 44.3% (n = 58) of the study population were current smokers, consisting of 60.7% of prisoners (n = 51) and 15.9% of staff (n = 7). Post-intervention, 45.1% of prisoners (n = 23/51) and 100% of staff (n = 7/7) who identified as current smokers pre-intervention reported abstinence from smoking. Among non-smokers, the proportion reporting being exposed to someone else’s cigarette smoke while being a resident or working in the unit decreased from 69.4% (n = 50/72) pre-intervention to 27.8% (n = 20/72) post-intervention (p < 0.001). This multicomponent intervention resulted in high abstinence rates, had high acceptability among both staff and prisoners, and was associated with wider health benefits across the prison setting.
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Affiliation(s)
- Andrea Bowe
- Health Intelligence Unit, Strategic Planning and Transformation, Health Service Executive, Dublin, Ireland;
- Correspondence:
| | - Louise Marron
- Department of Public Health, Health Service Executive, Dr. Steevens’ Hospital, Dublin, Ireland;
| | - John Devlin
- Irish Prison Service Irish, IDA Business Park, Ballinalee Road, Longford, Ireland;
| | - Paul Kavanagh
- Health Intelligence Unit, Strategic Planning and Transformation, Health Service Executive, Dublin, Ireland;
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Picot-Ngo C, Kivits J, Chevreul K. Réduire le tabagisme dans les prisons : éléments théoriques et méthodologiques nécessaires à la co-construction d’une intervention en contexte pénitentiaire. Glob Health Promot 2021. [DOI: 10.1177/1757975921993434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Révélateur des inégalités sociales de santé, le tabagisme en établissement pénitentiaire exige des interventions visant sa réduction d’être adaptées aux spécificités du milieu carcéral. Dans le cadre de la recherche interventionnelle TABAPRI, nous avons mobilisé une première étude sociologique afin d’apporter des connaissances sur cette problématique. Une enquête a été réalisée au sein de trois établissements pénitentiaires, précédant les phases de construction, d’implémentation et d’évaluation de l’intervention. Cet article décrit d’une part la démarche méthodologique et d’autre part, la contribution de la sociologie, tant dans ses apports conceptuels que méthodologiques, à la construction d’une intervention. Notre travail a notamment souligné l’importance d’aménager des espaces d’échange permettant aux professionnels et aux personnes détenues de construire ensemble les modalités d'intervention qui participent à la réduction du tabagisme en détention.
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Affiliation(s)
- Clément Picot-Ngo
- UMR 1123 Eceve, Institut national de la santé et de la recherche médicale (Inserm), Université de Paris, Paris, France
- Observatoire français des drogues et des toxicomanies (OFDT), Paris, France
| | - Joëlle Kivits
- Université de Lorraine, Unité « Adaptation, mesure et évaluation en santé. Approches interdisciplinaires » (APEMAC), Nancy, France
| | - Karine Chevreul
- UMR 1123 Eceve, Institut national de la santé et de la recherche médicale (Inserm), Université de Paris, Paris, France
- URC Eco Île-de-France (AP-HP, Hôtel Dieu), Paris, France
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6
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Brown A, Eadie D, Purves R, Mohan A, Hunt K. Perspectives on smokefree prison policy among people in custody in Scotland. Int J Prison Health 2020; 16:389-402. [PMID: 33634669 PMCID: PMC7810021 DOI: 10.1108/ijph-12-2019-0065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose This paper aims to explore smokefree prison policy, from the perspective of people in custody in Scotland. Design/methodology/approach In total, 77 people in custody in Scotland were interviewed in the period leading up to implementation of a nationwide prison smokefree policy. Data were thematically analysed to identify the diversity of views and experiences. Findings Participants described a widespread awareness in prisons of plans to implement a smokefree policy from 30 November 2018. Opinions about smokefree prisons varied among participants based on perceptions of the fairness, and anticipated positive and negative consequences of removing tobacco from prisons. At the time of the interviews, people in custody were responding to the impending smokefree policy, either by proactively preparing for the smokefree rule change or by deploying avoidance strategies. Participants described opportunities and challenges for implementing smokefree policy in prisons across three main themes: the role of smoking in prison, prison smoking cessation services and motivations for quitting smoking among people in custody. Originality/value This study exploring smokefree prisons from the perspectives of people in custody has several novel features which extend the evidence base. The findings highlight measures for jurisdictions to consider when planning to prohibit smoking in their prisons in the future. These include the need for evidence-based smoking cessation support in advance of smokefree policy, effective communication campaigns, consideration of broader structural determinants of health in prison and ongoing measures to reduce rates of return to smoking post release.
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Affiliation(s)
- Ashley Brown
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Douglas Eadie
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Richard Purves
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Andrea Mohan
- School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | - Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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7
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Valera P, Acuna N, Vento I. The Preliminary Efficacy and Feasibility of Group-Based Smoking Cessation Treatment Program for Incarcerated Smokers. Am J Mens Health 2020; 14:1557988320943357. [PMID: 32705965 PMCID: PMC7383630 DOI: 10.1177/1557988320943357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Group-based tobacco dependence treatment has been known to help smokers to quit in general adult populations, but the feasibility and efficacy of this type of smoking cessation treatment in correctional settings remain uncertain. A 6-week group-based smoking cessation treatment with nicotine replacement therapy (NRT) in the form of nicotine patches was implemented in seven male prison facilities, in the Northeast, among smokers who were born biologically as male. Exhaled breath carbon monoxide (CO) levels were collected from participants at each session to confirm smoking status. Participants were evaluated at the 1-month post-group treatment follow-up to determine abstinence. Those who were lost to follow-up were recorded as continued smoking and not using NRT nicotine patches. The goal of the study was to explore the feasibility and preliminary efficacy of conducting a smoking cessation treatment program for incarcerated smokers. A total of 350 inmates were screened, 177 inmates were enrolled across the prison sites for the 6-week program, and 102 inmates completed the program. A majority of those enrolled reported that they began smoking when they were between 15 and 19 years of age (44.9%) and were smoking on average for 26 years. Less than half (21.3%) reported ever using electronic cigarettes at baseline and in Session 1,116 individuals who attended reported a median CO level of 18.0 parts per million (ppm). At a 1-month follow-up, 43 individuals reported a median CO level of 5.00 ppm. The study demonstrated preliminary efficacy and feasibility of group-based smoking cessation treatment with NRT nicotine patches in incarcerated smokers.
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Affiliation(s)
- Pamela Valera
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
| | - Nicholas Acuna
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
| | - Ismary Vento
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
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8
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Brown A, Sweeting H, Logan G, Demou E, Hunt K. Prison Staff and Prisoner Views on a Prison Smoking Ban: Evidence From the Tobacco in Prisons Study. Nicotine Tob Res 2020; 21:1027-1035. [PMID: 29767777 PMCID: PMC6636247 DOI: 10.1093/ntr/nty092] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/08/2018] [Indexed: 11/29/2022]
Abstract
Introduction In jurisdictions permitting prisoner smoking, rates are high (c75%), with smoking embedded in prison culture, leading to secondhand smoke exposures among staff and prisoners and challenges for smoking cessation. Momentum is building to ban smoking in prisons, but research on staff and prisoner views is lacking. We address this gap, providing evidence on staff and prisoner views throughout all Scottish prisons. Methods Data were collected prior to the announcement of a (November 2018) prison smoking ban throughout Scotland. Mixed methods were used: surveys of staff (online, N = 1271, ~27%) and prisoners (questionnaire, N = 2512, ~34%); 17 focus groups and two paired interviews with staff in 14 prisons. Results Staff were more positive than prisoners about bans and increased smoking restrictions, although prisoner views were more favorable should e-cigarettes be permitted. Nonsmokers were more positive than smokers. Whilst 74% staff and 22% prisoners agreed bans were a good idea, both groups acknowledged implementation and enforcement challenges. Staff views were influenced by beliefs about: acceptability of the policy in principle and whether/how bans could be achieved. Although some voiced doubts about smoke-free policies, staff likened a ban to other operational challenges. Staff raised concerns around needs for appropriate measures, resources and support, adequate lead-in time, and effective communication prior to a ban. Conclusion We recommend that regular and open opportunities for dialogue within and between different stakeholder groups are created when preparing for prison smoking bans and that specific measures to address staff and prisoner concerns are incorporated into plans to create and maintain smoke-free environments. Implications To our knowledge, this study is the first to research staff and prisoner views across a whole prison system prior to implementation of smoke-free policies. The results highlight potential challenges and suggest measures, which might help to maximize the success of bans. Our results are relevant for prison service managers responsible for the forthcoming introduction of a ban in Scottish prisons (November 2018) and for other prison systems and comparable institutions planning smoke-free initiatives. Given that prison smoking bans may be contentious, we recommend creating regular and open opportunities for dialogue between stakeholders when preparing for and maintaining smoke-free environments.
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Affiliation(s)
- Ashley Brown
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Greig Logan
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Kate Hunt
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
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Johnson C, Chaput JP, Diasparra M, Richard C, Dubois L. How did the tobacco ban increase inmates' body weight during incarceration in Canadian federal penitentiaries? A cohort study. BMJ Open 2019; 9:e024552. [PMID: 31315854 PMCID: PMC6661556 DOI: 10.1136/bmjopen-2018-024552] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This study aimed to determine how inmates' body weight changed during incarceration in Canadian federal penitentiaries, based on their history of tobacco use. Since tobacco was banned from all Canadian federal penitentiaries in 2008, little is known about the unintended health consequences of this ban, especially on inmates' body weight. DESIGN Cohort study. SETTING Participants were male and female inmates incarcerated for at least 6 months in Canadian federal penitentiaries. We collected data from 10 institutions in two Canadian regions (Ontario and Atlantic). PARTICIPANTS We collected data from 754 inmates who volunteered to participate in the study. INTERVENTION This study examined weight change in relation to a history of tobacco use. In 2016-2017, anthropometric data were collected and compared with recorded anthropometric data at the beginning of incarceration (mean follow-up of 5.0±8.3 years). Self-reported data on tobacco and substance use were collected. Weight change was compared between inmates with and without a history of tobacco use. OUTCOMES The main outcome measures were body weight change (kg), body mass index (BMI) change (kg/m2), annual weight change (kg/year), and BMI and waist circumference (cm) at the time of the interview. RESULTS During incarceration, ex-smokers gained more than twice the amount of weight compared with non-smokers (7.5 kg weight gain for smokers vs 3.7 kg weight gain for non-smokers). Once adjusted for covariates in a regression analysis, for inmates who gained the most weight (75th and 90th percentiles), non-smokers had, respectively, 1.64 and 2.3 lower BMI points than ex-smokers. CONCLUSIONS During incarceration in Canadian federal penitentiaries, inmates with a history of tobacco use gained significantly more weight than non-smokers. This put them at increased risk of developing obesity-related health problems. This information is important for the prison setting when planning related programmes and regulation.
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Affiliation(s)
- Claire Johnson
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jean-Philippe Chaput
- Department of Human Nutrition, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Maikol Diasparra
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Catherine Richard
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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10
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Puljević C, Coomber R, de Andrade D, Kinner SA. Barriers and facilitators of maintained smoking abstinence following release from smoke-free prisons: A qualitative enquiry. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 68:9-17. [PMID: 30974331 DOI: 10.1016/j.drugpo.2019.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 01/24/2019] [Accepted: 03/11/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND The prevalence of smoking among people entering prisons is high. Despite increasing adoption of prison smoke-free policies, relapse to smoking after release from prison is nearly universal, and policy to effectively mitigate this is largely absent. Informed by a risk environment framework, we aimed to identify key barriers and facilitators to maintaining smoking abstinence among former smokers released from smoke-free prisons. METHOD Twenty-one people released from smoke-free prisons in Queensland, Australia, were followed up from a larger survey of 114 former prisoners. Semi-structured interviews were used to explore the perceived barriers and facilitators of maintained smoking abstinence. FINDINGS Identified barriers to continued abstinence included pre-release intention to resume smoking; normalisation of smoking in home or social environments, resumption of smoking as a symbolic act of freedom and resistance from and to a restrictive environment; a perception that smoking provides stress relief to their difficult lives, and the use of tobacco/smoking to cope with cravings experienced on release for illicit substances. A number of interviewees were unable to provide clear reflective reasons for relapse. For those who did manage to remain abstinent for a period of time, identified facilitators included an awareness of the health and financial benefits of smoking abstinence, the use of intrinsic motivation, distraction from nicotine cravings using alternative activities, and social support from family and peers. DISCUSSION Interventions promoting continued smoking abstinence among people exiting smoke-free prisons should focus on targeting the perceived individual- and environmental-level barriers to maintained smoking abstinence while simultaneously promoting perceived facilitators, so as to reduce smoking-related health and economic disparities in this marginalised population.
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Affiliation(s)
- Cheneal Puljević
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia; Griffith Criminology Institute, Griffith University, Brisbane, Australia.
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, Brisbane, Australia; Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, United Kingdom; School of Justice, Queensland University of Technology, Brisbane, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, Brisbane, Australia; Lives Lived Well Research Group, School of Psychology, The University of Queensland, Brisbane, Australia; Centre for Youth Substance Abuse Research, School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne Australia; Mater Research Institute-UQ, The University of Queensland, Brisbane, Australia
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11
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Ahalt C, Buisker T, Myers J, Williams B. Smoking and Smoking Cessation Among Criminal Justice-Involved Older Adults. Tob Use Insights 2019; 12:1179173X19833357. [PMID: 30890860 PMCID: PMC6416677 DOI: 10.1177/1179173x19833357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 02/02/2019] [Indexed: 12/24/2022] Open
Abstract
Background In jails and prisons worldwide, older adults are among the fastest growing demographic groups. Criminal justice-involved populations smoke tobacco at high rates. Older adults are also disproportionate smokers and have more difficulty quitting smoking than other age groups. Yet, little is known about tobacco use or knowledge and attitudes toward smoking cessation among the growing population of incarcerated older adults. Methods A descriptive, cross-sectional survey study of 102 adults aged 55 years or older recently incarcerated in an urban jail using items from the Global Adult Tobacco Survey (GATS). Results More than 70% of participants reported being current smokers despite strong knowledge (95%) of the connection between smoking and serious illness. More than half of current smokers reported a past failed quit attempt (62%) and/or said they would like to quit (60%). Conclusions High rates of tobacco use in this population suggest that correctional institutions represent a critical site for the delivery of appropriate smoking cessation interventions to older adults, including integrated treatment approaches for those with co-occurring behavioral health diagnoses.
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Affiliation(s)
- Cyrus Ahalt
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Timothy Buisker
- Epidemiology Division, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Janet Myers
- Center for AIDS Prevention Studies and Prevention Research Center, University of California, San Francisco, San Francisco, CA, USA
| | - Brie Williams
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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12
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Dugdale S, Semper H, Povey R, Elison-Davies S, Davies G, Ward J. Offenders' perceptions of the UK prison smoking ban. Int J Prison Health 2019; 15:114-125. [PMID: 31172853 DOI: 10.1108/ijph-06-2018-0034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Despite overall reductions in levels of smoking in the UK, rates of offender smoking remain high. In 2016, it was announced that prisons in England and Wales would gradually introduce a smoking ban. The purpose of this paper is to explore offenders' perceptions around the upcoming smoking ban. DESIGN/METHODOLOGY/APPROACH A total of eight focus groups were conducted in four prisons across the North of England. Both smoking and non-smoking offenders participated in the focus groups, and thematic analysis was used to explore the findings. FINDINGS Themes generated from the data were "freedom and rights", "the prison environment" and "guiding support". Participants discussed how the smoking ban was viewed as a punishment and restricted their freedom, with perceptions as to why the ban was being implemented centring around others trying to control them. Participants expressed concerns around the financial implications of the smoking ban on already stretched prison resources. Participants also recommended improving the nicotine replacement therapy on offer, and increasing the range of leisure activities within the prison to prepare for the smoking ban. ORIGINALITY/VALUE Overall, it was apparent that participants' awareness of the smoking ban was generally poor. It is recommended that offenders need to be made more aware of the smoking cessation support they will receive and given the opportunity to ask questions about the smoking ban. Increasing offenders' awareness of the ban may reduce stress associated with a perceived lack of choice around their smoking behaviours.
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Affiliation(s)
- Stephanie Dugdale
- Department of Research and Development, Breaking Free Group, Manchester, UK
| | - Heather Semper
- Faculty of Health Sciences, Staffordshire University , Stoke-on-Trent, UK
| | - Rachel Povey
- Faculty of Health Sciences, Staffordshire University , Stoke-on-Trent, UK
| | | | - Glyn Davies
- Department of Research and Development, Breaking Free Group, Manchester, UK
| | - Jonathan Ward
- Department of Research and Development, Breaking Free Group, Manchester, UK
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13
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Mitchell C, Puljević C, Coomber R, White A, Cresswell SL, Bowman J, Kinner SA. Constituents of "teabacco": A forensic analysis of cigarettes made from diverted nicotine replacement therapy lozenges in smoke-free prisons. Drug Test Anal 2019; 11:140-156. [PMID: 30109771 DOI: 10.1002/dta.2471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 11/06/2022]
Abstract
Following the implementation of prison smoke-free policies, there have been reports of prisoners creating substitute cigarettes made from nicotine replacement therapy patches or lozenges infused with tea leaves ("teabacco"). No studies have analyzed the chemical constituents of teabacco made from nicotine lozenges, so as to document any potential related health hazards. Teabacco samples were made by a participant who reported creating teabacco while incarcerated in a smoke-free prison in Queensland, Australia, and the process was video-recorded for replication in a laboratory. A simple linear smoking system captured the teabacco smoke for analysis. Inductively coupled plasma optical emission spectroscopy (ICP-OES) was used to analyze elemental composition and gas chromatography coupled with a mass spectrometer (GC-MS) analyzed the captured smoke using the National Institute of Standards and Technology mass spectral library. Analyses determined that quantities of copper, aluminum, and lead concentrations, and levels of inhaled total particulate matter, were above recommended guidelines for safe ingestion. Analysis of teabacco smoke using GC-MS identified potentially toxic compounds catechol and nicotine. However, our findings show that smoking this form of teabacco is less harmful than smoking teabacco made from nicotine patches, or smoking traditional tobacco cigarettes. Considering the limited potential health harm of smoking teabacco made from lozenges, and that nicotine lozenges represent the only form of smoking cessation support for individuals entering smoke-free prisons, we caution against the removal of nicotine lozenges from Queensland's prisons, at least until further research directly establishes health harms associated with this form of teabacco.
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Affiliation(s)
- Courtney Mitchell
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, United Kingdom
| | - Alan White
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Sarah L Cresswell
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Jasper Bowman
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Mater Research Institute-UQ, The University of Queensland, Brisbane, Australia
- Netherlands Institute for the Study of Crime and Law Enforcement, Amsterdam, Netherlands
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14
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Puljević C, Coomber R, Kinner SA, de Andrade D, Mitchell C, White A, Cresswell SL, Bowman J. 'Teabacco': Smoking of nicotine-infused tea as an unintended consequence of prison smoking bans. Drug Alcohol Rev 2018; 37:912-921. [PMID: 30051520 DOI: 10.1111/dar.12848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/21/2018] [Accepted: 06/29/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION AND AIMS Following the introduction of smoke-free policies in prisons in several countries, there have been anecdotal reports of prisoners creating cigarettes by mixing nicotine patches or lozenges with tea leaves ('teabacco'). Among a sample of people recently released from smoke-free prisons in Queensland, Australia, the aims of this study were to explore the perceived popularity of teabacco use, motivations for its use and describe the process of creating teabacco to identify potential associated health risks. DESIGN AND METHODS This study used a mixed-methods design. Eighty-two people recently released from prison in Queensland, Australia completed surveys at parole offices measuring teabacco use while incarcerated. Twenty-one teabacco smokers took part in follow-up, qualitative interviews to explore survey responses in greater depth. RESULTS The majority of survey participants (57%) reported smoking teabacco while incarcerated, with 37% smoking teabacco frequently (> once per week). Teabacco use was primarily motivated by cigarette cravings. Participants described the perceived inevitability of prisoners finding substitutes for tobacco. Multivariate analyses found that self-rated poor physical health, having been incarcerated five or more times, experiencing cigarette cravings while incarcerated, and use of illicit drugs while incarcerated were positively associated with frequent teabacco use in prison. DISCUSSION AND CONCLUSIONS Our findings suggest that teabacco use has become common practice in Queensland's smoke-free prisons. Correctional smoking bans are an important public health initiative but should be complemented with demand and harm reduction measures cognisant of the risk environment.
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Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia.,The Institute for Social Science Research, The University of Queensland, Brisbane, Australia
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, UK
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Mater Research Institute-UQ, University of Queensland, Brisbane, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,School of Psychology, University of Queensland, Brisbane, Australia.,Centre for Youth Substance Abuse Research, School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Courtney Mitchell
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Alan White
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Sarah L Cresswell
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Jasper Bowman
- School of Environment and Science, Griffith University, Brisbane, Australia
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Semple S, Sweeting H, Demou E, Logan G, O'Donnell R, Hunt K. Characterising the Exposure of Prison Staff to Second-Hand Tobacco Smoke. Ann Work Expo Health 2018; 61:809-821. [PMID: 28810685 PMCID: PMC6684365 DOI: 10.1093/annweh/wxx058] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 06/28/2017] [Indexed: 11/29/2022] Open
Abstract
Second-hand tobacco smoke (SHS) is an avoidable and harmful exposure in the workplace but >25000 prison staff continue to be exposed on a daily basis in the UK and many more worldwide. SHS exposures in prisons are incompletely understood but may be considerable given the large proportion of smoking prisoners and limited ventilation. This study characterized the exposure of prison staff to SHS in all 15 prisons in Scotland using multiple methods. Exposure assessment strategies included 6-day area measurement of fine Particulate Matter (PM2.5) and airborne nicotine in each prison together with short (30-minute) measurements of PM2.5 covering a range of locations/activities. Pre- and post-shift saliva samples were also gathered from non-smoking staff and analysed for cotinine to estimate exposure. There was evidence of exposure to SHS in all prisons from the results of PM2.5 and nicotine measurements. The salivary cotinine results from a sub-sample of non-smoking workers indicated SHS exposures of similar magnitude to those provided by the 6-day area measurements of PM2.5. There was a high degree of exposure variability with some locations/activities involving exposure to SHS concentrations that were comparable to those measured in bars in Scotland prior to smoke-free legislation in 2006. The median shift exposure to SHS-PM2.5 was ~20 to 30 µg m−3 and is broadly similar to that experienced by someone living in a typical smoking home in Scotland. This is the most comprehensive assessment of prison workers’ exposure to SHS in the world. The results are highly relevant to the development of smoke-free policies in prisons and should be considered when deciding on the best approach to provide prison staff with a safe and healthy working environment.
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Affiliation(s)
- Sean Semple
- Respiratory Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZG, UK
| | - Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, 200 Renfield Street, Glasgow G2 3QB, UK
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, 200 Renfield Street, Glasgow G2 3QB, UK
| | - Greig Logan
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, 200 Renfield Street, Glasgow G2 3QB, UK
| | - Rachel O'Donnell
- Respiratory Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZG, UK
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, 200 Renfield Street, Glasgow G2 3QB, UK
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16
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Puljević C, de Andrade D, Coomber R, Kinner SA. Relapse to smoking following release from smoke-free correctional facilities in Queensland, Australia. Drug Alcohol Depend 2018; 187:127-133. [PMID: 29660697 DOI: 10.1016/j.drugalcdep.2018.02.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/05/2018] [Accepted: 02/26/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Smoke-free prison policies are increasingly common, but few studies have investigated relapse to smoking after release from prison. This study investigated return to tobacco smoking and correlates of smoking at reduced levels after release among adults recently released from smoke-free prisons in Queensland, Australia. METHODS A cross-sectional survey of 114 people at parole offices within two months of release from prison was used. The survey measured health, social, and criminological factors related to tobacco smoking. We used logistic regression to identify factors associated with reduced post-release smoking levels compared to pre-incarceration levels. RESULTS 94% of participants relapsed to smoking within two months of release; 72% relapsed on the day of release. 62% of participants smoked significantly less per day after compared with before incarceration. Living with a partner (Odds Ratio (OR) 2.77, 95%CI 1.02-7.52), expressing support for smoke-free prison policies (OR 2.44, 95%CI 1.12-5.32), intending to remain abstinent post-release (OR 4.29, 95%CI 1.88-9.82), and intending to quit in the future (OR 3.88, 95%CI 1.66-9.07) were associated with reduced smoking post-release. Use of illicit drugs post-release was negatively associated with reduced smoking post-release (OR 0.27, 95%CI 0.09-0.79). In multivariate analyses, pre-release intention to remain smoke-free was associated with reduced smoking post-release (AOR 2.69, 95%CI 1.01-7.14). DISCUSSION Relapse to smoking after release from smoke-free prisons is common, but many who relapse smoke less than before incarceration, suggesting that smoke-free prison policies may reduce post-release tobacco smoking. There is a need for tailored, evidence-based tobacco cessation interventions for people recently released from prison.
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Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, 176 Messines Ridge Rd., Mt. Gravatt, Queensland, 4122, Australia; Queensland Alcohol and Drug Research and Education Centre, School of Public Health, University of Queensland, 288 Herston Rd, Herston, Queensland, 4006, Australia; Institute for Social Science Research, University of Queensland, 80 Meiers Rd, Indooroopilly, Queensland, 4068, Australia.
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, 176 Messines Ridge Rd., Mt. Gravatt, Queensland, 4122, Australia; School of Psychology, University of Queensland, Sir Fred Schonell Dr., St. Lucia, Queensland, 4072, Australia; Centre for Youth Substance Abuse Research, School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Queensland, 4072, Australia
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, 176 Messines Ridge Rd., Mt. Gravatt, Queensland, 4122, Australia
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, 176 Messines Ridge Rd., Mt. Gravatt, Queensland, 4122, Australia; Melbourne School of Population and Global Health, University of Melbourne, 235 Bouverie St., Carlton, Victoria, 3053, Australia; School of Public Health and Preventive Medicine, Monash University, Scenic Blvd., Clayton, Victoria, 3800, Australia; Mater Research Institute-UQ, University of Queensland, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Rd., Parkville, Melbourne, Victoria, Australia; Netherlands Institute for the Study of Crime and Law Enforcement, PO Box 71304, 1008 BH, Amsterdam, Netherlands
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17
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Breaking Free from Smoking: A Novel Digital Smoking Cessation Intervention for Offenders in UK Prisons. J Smok Cessat 2018. [DOI: 10.1017/jsc.2018.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction: The level of smoking cessation support across UK prisons is variable, with most offering pharmacological support, such as nicotine replacement therapy. However, with a complete smoking ban in prisons in England now imminent, additional standardised behavioural support is necessary to help offenders go smoke-free.Aims: This study used the Behaviour Change Wheel to aim to develop the content of an online smoking cessation intervention for offenders, with consideration of their capability, motivation and opportunity for behaviour change.Methods: This was an intervention development study. The Behaviour Change Wheel was used to map cognitive, behavioural, physiological and social targets for the intervention, onto appropriate intervention techniques for inclusion in the smoking cessation programme for offenders.Results: Psychological capability, social opportunity and reflective and automatic motivation were identified through deductive thematic analysis as areas of change required to achieve smoking cessation. A total of 27 behavioural change techniques were chosen for this smoking cessation intervention and were mapped onto the Lifestyle Balance Model which provided the theoretical basis on which the components of the programme are conceptualised. This included strategies around increasing motivation to quit, anticipating smoking triggers, modifying smoking-related thoughts, regulating emotions, managing cravings, replacing smoking and rewarding nicotine abstinence and adopting a healthier lifestyle.Conclusions: Through the utilisation of the Behaviour Change Wheel, the development process of this digital smoking cessation intervention was achieved. Further research is planned to evaluate the clinical effectiveness of this intervention and to explore how the programme is implemented in practice within prison settings.
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18
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Woodall J, Tattersfield A. Perspectives on implementing smoke-free prison policies in England and Wales. Health Promot Int 2017; 33:1066-1073. [DOI: 10.1093/heapro/dax031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- James Woodall
- Reader in Health Promotion, Leeds Beckett University, Leeds, UK
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19
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Thomas M, Richmond R. Addressing the arguments against implementation of smoke-free policies in psychiatric facilities. J Psychiatr Ment Health Nurs 2017; 24:322-331. [PMID: 28261996 DOI: 10.1111/jpm.12383] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M Thomas
- New South Wales Ministry of Health, North Sydney, NSW, Australia.,School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney, NSW, Australia
| | - R Richmond
- School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney, NSW, Australia
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20
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Djachenko A, St John W, Mitchell C. Smoking cessation in smoke-free prisons: a grounded theory study. Int J Prison Health 2016; 12:270-279. [DOI: 10.1108/ijph-06-2016-0019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Prisoners are vulnerable to tobacco addiction and have a smoking prevalence significantly higher than that of the general community. The context of this study was the implementation of a “smoke-free prisons” policy, which imposed forced smoking cessation onto the Queensland, Australian prison population. The study asked the question: “What are the psychosocial processes in which male prisoners engage during smoking cessation in a smoke-free environment?”
Design/methodology/approach
Qualitative interviews were conducted with 15 prisoners in South-east Queensland smoke-free correctional centres. Grounded theory methodology was applied to construct a theory of the processes of smoking cessation.
Findings
The constructed theory was named Engaging with Quitting. In this model, prisoners proceed through a cycle of evaluations, adjustments and reflections on their reality as related to the smoke-free prison. The study gives first-hand accounts of the prisoners’ use (and abuse) of nicotine replacement therapy. Three personality typologies emerged from the data: The Angry Smoker, the Shifting Opportunist and the Optimistic Quitter.
Research limitations/implications
This qualitative study makes no claim of generalisability and cannot be taken to represent all prisoners. Females, youths and culturally diverse prisoners were not represented in the sample.
Practical implications
Smoking cessation in prisons must be recognised as an ongoing process, rather than a discrete event. A coordinated approach between custodial and health authorities is required to minimise maladaptive coping strategies.
Originality/value
This study provides a descriptive account of the processes prisoners undertake during involuntary smoking cessation and has described the manner in which prisoners manufacture home-made tobacco from nicotine patches. The study has produced an original theory named Engaging with Quitting.
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21
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Howell BA, Guydish J, Kral AH, Comfort M. Prevalence and factors associated with smoking tobacco among men recently released from prison in California: A cross-sectional study. Addict Behav 2015; 50:157-60. [PMID: 26150399 DOI: 10.1016/j.addbeh.2015.06.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 05/03/2015] [Accepted: 06/04/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Over 1.5 million people are incarcerated in state and federal correctional facilities in the United States. Formerly incarcerated men have significantly higher rates of mortality and morbidity than the general population, disparities that have been partially attributed to higher rates of tobacco smoking-related illnesses such as cardiovascular disease, pulmonary disease and cancer. METHODS We compared the prevalence of smoking tobacco in a sample of 172 men who were released from California state prisons to Oakland and San Francisco between 2009 and 2011 to sub-populations of respondents to the 2009 California Health Interview Survey (CHIS). Using logistic regression, we analyzed the association between lifetime history of incarceration and self-reported smoking status. RESULTS Seventy-four percent of men recently released from prison reported being current tobacco smokers. The prevalence of smoking in a demographically similar group of men in the CHIS was 24%. We found in bivariate analysis that each additional five years of history of incarceration was associated with 1.32 times greater odds of smoking (95% CI 1.02 to 1.71). Illicit substance use was associated with a 2.47 higher adjusted odds of smoking (95% CI 1.29 to 5.39). In the multivariate model adjusting for age, income, substance use and mental health, every five years of incarceration was associated with 1.23 greater odds of smoking (95% CI 0.94 to 1.63) which was not statistically significant. CONCLUSIONS Given the high prevalence of smoking tobacco among former prisoners and the underlying high tobacco-related mortality rates, these findings suggest that a history of incarceration may be an important determinant of smoking. Prison and parole systems may be important potential settings for smoking-cessation interventions.
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Affiliation(s)
- Benjamin A Howell
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Joseph Guydish
- Philip R Lee Health Policy Institute, University of San Francisco, San Francisco, CA, USA
| | - Alex H Kral
- Behavioral and Urban Health Program, RTI International, San Francisco, CA, USA
| | - Megan Comfort
- Behavioral and Urban Health Program, RTI International, San Francisco, CA, USA.
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22
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Ritter C, Gayet-Ageron A, Buth S, Stöver H. Tobacco use among prison staff in Germany: a cross-sectional study. Eur J Public Health 2015; 26:339-43. [PMID: 26498955 DOI: 10.1093/eurpub/ckv195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Studies on tobacco in the prison environment report high prevalence of use among detainees, but little data regarding staff are available. An observational study addressing tobacco control in German prisons was conducted in 2011. It involved multiple strands (quantitative and qualitative components) both among detainees and staff. This article presents quantitative results regarding staff. METHODS Cross-sectional study among prison employees in 16 different institutions in nine regions (Länder) in Germany. Tobacco use and second-hand smoke (SHS) exposure (primary outcomes) were assessed by a questionnaire designed specifically. Logistic regression models were used to assess the risk factors associated with each outcome. RESULTS Among 704 participants (60.6% male, mean age 43.9 years ± 9.33), 27.7% are smokers and 68% declared to be exposed to SHS. Independent factors associated with smoking were female gender [odds ratio (OR) 1.49,P= 0.026], an age below 45 years (OR 1.35,P= 0.08) and working in areas other than administration (ORP= 0.08). An age below 45 was associated with a higher degree of self-reported SHS exposure. The association between SHS and gender was different depending on occupational area with significantly more men exposed to SHS in administrative area and more women in health/social area (interaction between gender and occupational area,P= 0.02). CONCLUSION Importance of SHS exposure among prison employees and confirm the need for a comprehensive tobacco control policy including support to smoking cessation and better enforcement of the smoke-free regulation, especially where staff contributes to SHS. Particular attention has to be given to female employees.
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Affiliation(s)
- C Ritter
- 1 Department of Health, Frankfurt University of Applied Sciences, Frankfurt am Main, Germany
| | - A Gayet-Ageron
- 2 Clinical Research Center & Division of Clinical Epidemiology, Department of Health and Community Medicine, Geneva University Hospital, Geneva, Switzerland
| | - S Buth
- 3 Center for Interdisciplinary Addiction Research (CIAR), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Stöver
- 4 Department of Health, Frankfurt University of Applied Sciences, Frankfurt am Main, Germany
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23
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Valera P, Anderson M, Cook SH, Wylie-Rosett J, Rucker J, Reid AE. The smoking behaviors and cancer-related disparities among urban middle aged and older men involved in the criminal justice system. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:86-93. [PMID: 24832966 PMCID: PMC4234703 DOI: 10.1007/s13187-014-0668-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examined cancer knowledge, mental health, and tobacco use in formerly incarcerated men. The Cancer-Health Research Study with Formerly Incarcerated Men in New York City used a cross-sectional research design to examine cancer knowledge and prevention (CKP) outcomes among 259 justice-involved males, ages 35-67. CKP was assessed using items from the National Cancer Institute's Health Information National Trends Survey. Psychological symptoms were examined using the Brief Symptom Inventory. Of the 259 men who completed the survey, 76% of the respondents self-reported as current smokers. Current smokers smoked between 1 and 40 cigarettes per day. The mean number of cigarettes smoked per day was 10.37 (SD = 6.76). Sixty-five percent (n = 165) of the respondents underwent cancer-screening tests. CKP scores ranged from 2 to 28; the mean was 15.05 (SD = 5.49), indicating that the men scored very low in terms of CKP. CKP scores were negatively associated with the number of cigarettes smoked per day, τ = -.13, p = .01. These results have important implications for enhancing access to cancer-health education programs in justice-involved settings.
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Affiliation(s)
- Pamela Valera
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722W. 168th Street, Room 940, New York, NY, 10032, USA,
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Naik S, Khanagar S, Kumar A, Ramachandra S, Vadavadagi SV, Dhananjaya KM. Assessment of effectiveness of smoking cessation intervention among male prisoners in India: A randomized controlled trial. J Int Soc Prev Community Dent 2015; 4:S110-5. [PMID: 25558450 PMCID: PMC4278102 DOI: 10.4103/2231-0762.146213] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Tobacco smoking is an integral part of prison life and an established part of the culture. Little attention has been paid to prevention of smoking in prison. Approximately 70–80% of prisoners have been identified as current smokers. Aim: To assess the effectiveness of smoking cessation intervention among male prisoners at Central Jail, Bangalore city. Aim: To assess the effectiveness of smoking cessation intervention among male prisoners at Central Jail, Bangalore city. Materials and Methods: A randomized controlled trial was planned among male prisoners in Central Jail, Bangalore city. There were 1600 convicted prisoners. A self-administered questionnaire was given to the prisoners to assess their smoking behavior by which prevalence of tobacco smoking was found. Exactly 1352 tobacco users were studied. Among them, there were 1252 smokers. Based on inclusion criteria and informed consent given by the prisoners, a sample of 600 was chosen for the study by systematic random sampling. Among the 600 prisoners, 300 were randomly selected for the study group and 300 for the control group. Results: Prevalence of tobacco smoking among the prisoners was 92.60%. In the present study, after smoking cessation intervention, 17% showed no change in smoking, 21.66% reduced smoking, 16% stopped smoking, and 45.33% relapsed (P < 0.0001) at the end of 6-month follow-up in the study group. Conclusion: Tobacco use was high among the prisoners. Tobacco reduction is possible in the prison even if the living conditions are not favorable. Relatively high rate of relapse in our study indicates that some policies should be adopted to improve smokers’ information on consequences of tobacco on health and motivational intervention should be added to prisoners.
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Affiliation(s)
- Sachin Naik
- Department of Public Health Dentistry, Sri Jagadguru Murugarajendra Dental College and Hospital, Chitradurga, Karnataka, India
| | - Sanjeev Khanagar
- Department of Public Health Dentistry, Kurunji Venkatramana Gowda Dental College and Hospital, Mangalore, Karnataka, India
| | - Amit Kumar
- Department of Public Health Dentistry, Sarjug Dental College and Hospital, Darbhanga, Bihar, India
| | - Sujith Ramachandra
- Department of Conservative Dentistry, Sri Jagadguru Murugarajendra Dental College and Hospital, Chitradurga, Karnataka, India
| | - Sunil V Vadavadagi
- Department of Prosthodontics, Sri Jagadguru Murugarajendra Dental College and Hospital, Chitradurga, Karnataka, India
| | - Kiran Murthy Dhananjaya
- Department of Conservative Dentistry, Sri Jagadguru Murugarajendra Dental College and Hospital, Chitradurga, Karnataka, India
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Binswanger IA, Carson EA, Krueger PM, Mueller SR, Steiner JF, Sabol WJ. Prison tobacco control policies and deaths from smoking in United States prisons: population based retrospective analysis. BMJ 2014; 349:g4542. [PMID: 25097186 PMCID: PMC4122735 DOI: 10.1136/bmj.g4542] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the mortality attributable to smoking and years of potential life lost from smoking among people in prison and whether bans on smoking in prison are associated with reductions in smoking related deaths. DESIGN Analysis of cross sectional survey data with the smoking attributable mortality, morbidity, and economic costs system; population based time series analysis. SETTING All state prisons in the United States. MAIN OUTCOME MEASURES Prevalence of smoking from cross sectional survey of inmates in state correctional facilities. Data on state prison tobacco policies from web based searches of state policies and legislation. Deaths and causes of death in US state prisons from the deaths in custody reporting program of the Bureau of Justice Statistics for 2001-11. Smoking attributable mortality and years of potential life lost was assessed from the smoking attributable mortality, morbidity, and economic costs system of the Centers for Disease Control and Prevention. Multivariate Poisson models quantified the association between bans and smoking related cancer, cardiovascular and pulmonary deaths. RESULTS The most common causes of deaths related to smoking among people in prison were lung cancer, ischemic heart disease, other heart disease, cerebrovascular disease, and chronic airways obstruction. The age adjusted smoking attributable mortality and years of potential life lost rates were 360 and 5149 per 100,000, respectively; these figures are higher than rates in the general US population (248 and 3501, respectively). The number of states with any smoking ban increased from 25 in 2001 to 48 by 2011. In prisons the mortality rate from smoking related causes was lower during years with a ban than during years without a ban (110.4/100,000 v 128.9/100,000). Prisons that implemented smoking bans had a 9% reduction (adjusted incidence rate ratio 0.91, 95% confidence interval 0.88 to 0.95) in smoking related deaths. Bans in place for longer than nine years were associated with reductions in cancer mortality (adjusted incidence rate ratio 0.81, 95% confidence interval 0.74 to 0.90). CONCLUSIONS Smoking contributes to substantial mortality in prison, and prison tobacco control policies are associated with reduced mortality. These findings suggest that smoking bans have health benefits for people in prison, despite the limits they impose on individual autonomy and the risks of relapse after release.
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Affiliation(s)
- Ingrid A Binswanger
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Mail Stop B180, 12631 E 17th Avenue, Aurora, CO 80045, USA
| | - E Ann Carson
- Bureau of Justice Statistics, Department of Justice, 810 Seventh Street, NW, Washington, DC 20531, USA
| | - Patrick M Krueger
- Department of Health and Behavioral Sciences, University of Colorado Denver, Campus Box 188, PO Box 173364, Denver, CO 80217, USA
| | - Shane R Mueller
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Mail Stop B180, 12631 E 17th Avenue, Aurora, CO 80045, USA
| | - John F Steiner
- Institute for Health Research, Kaiser Permanente Colorado, PO Box 378066, Denver, CO 80237, USA
| | - William J Sabol
- Bureau of Justice Statistics, Department of Justice, 810 Seventh Street, NW, Washington, DC 20531, USA
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Valera P, Cook SH, Darout R, Dumont DM. "They are not taking cigarettes from me . . . I'm going to smoke my cigarettes until the day I die. I don't care if I get cancer": smoking behaviors of men under community supervision in New York City. Nicotine Tob Res 2014; 16:800-6. [PMID: 24480803 DOI: 10.1093/ntr/ntt280] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Cigarette smoking declined from 42.4% in 1965 to 19.3% in 2010 among the general population, but it remains the leading cause of preventable death and illness in the United States, especially among high-risk populations, including those with criminal justice involvement. METHODS A mixed-methods approach was used to investigate the smoking behaviors of men under parole or probation. Phase I focused on qualitative data of 30 semi-structured interviews of men who were recently released from a state prison and/or jail. Phase II analyzed quantitative data resulting from a study that examined smoking characteristics and treatment approaches of 259 participants, 197 of whom were cigarette smokers. RESULTS The survey participants' age of tobacco initiation ranged from 7 to 45 years of age. Participants smoked between 1 and 40 cigarettes per day; the mean number of cigarettes smoked per day was 10.37. Men released from prison used cigarettes for more years on average than men released from jail (t[194] = -2.22, p < .05). A linear regression procedure revealed that the influence of friends and family significantly predicted smoking behavior (β = .25, p < .0001). The qualitative data revealed the following themes: unintended consequences of the prison smoking ban, smoking as anxiety management, smoking cigarettes as part of a daily routine, and barriers to quitting. CONCLUSIONS Given the rapid growth of individuals under community supervision, public health and policy makers are missing an opportunity to develop strategies that promote smoking cessation treatments, especially among men who are serving parole or probation and during the incarceration period itself.
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Affiliation(s)
- Pamela Valera
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY
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Smoking and other drug characteristics of aboriginal and non-aboriginal prisoners in australia. JOURNAL OF ADDICTION 2013; 2013:516342. [PMID: 24940513 PMCID: PMC4008511 DOI: 10.1155/2013/516342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 03/01/2013] [Accepted: 03/10/2013] [Indexed: 11/21/2022]
Abstract
Introduction and Aim. Although tobacco and alcohol use have declined substantially in the Australian community, substance use among prisoners remains high. The aim was to compare the smoking, drug, and alcohol characteristics, sociodemographic profile, and general health of Aboriginal and non-Aboriginal male prisoners in a smoking cessation intervention. Design and Methods. This study was a descriptive cross-sectional analysis of data from 425 male prisoners who joined a quit smoking trial conducted at 18 correctional centres in NSW and Queensland using data collected by standardised self-report instruments. Results. Average age was 33 years with 15% from Aboriginal descent. Compared to non-Aboriginal prisoners, Aboriginal prisoners were significantly more likely to have left school with no qualifications, to have been institutionalised as a child, to be previously incarcerated, and commenced smoking at a younger age. The tobacco use profile of both groups was similar; most of them had a medium to high level of nicotine dependence, smoked roll your own tobacco, and were “serious” about quitting. Discussion and Conclusion. Despite differences in terms of sociodemographic characteristics and offending history, the smoking characteristics of Aboriginal and non- Aboriginal prisoners were similar. Incarceration offers an opportunity to encourage smoking cessation and reduction of drug use.
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Etter JF, Ritter C, Christie DH, Kunz M, Rieder JP, Humair JP, Wolff H, Eytan A, Wahl C, Elger B. Implementation and impact of anti-smoking interventions in three prisons in the absence of appropriate legislation. Prev Med 2012; 55:475-81. [PMID: 22971458 DOI: 10.1016/j.ypmed.2012.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 08/14/2012] [Accepted: 08/17/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To assess the acceptability and impact of anti-smoking policies in three prisons in Switzerland. METHODS A before-after intervention study in A) an open prison for sentenced prisoners, B) a closed prison for sentenced prisoners, and C) a prison for pretrial detainees. Prisoners and staff were surveyed before (2009, n=417) and after (2010-2011, n=228) the interventions. Medical staff were trained to address tobacco dependence systematically in prisoners. In prison A, a partial smoking ban was extended. No additional protection against second-hand smoke was feasible in prisons B and C. RESULTS In prison A, more prisoners reported receiving medical help to quit smoking in 2011 (20%) than in 2009 (4%, p=0.012). In prison A, prisoners and staff reported less exposure to second-hand smoke in 2011 than in 2009: 31% of prisoners were exposed to smoke at workplaces in 2009 vs 8% in 2011 (p=0.001); in common rooms: 43% vs 8%, (p<0.001). No changes were observed in prisons B and C. CONCLUSIONS Reinforcement of non-smoking rules was possible in only one of the three prisons but had an impact on exposure to tobacco smoke and medical help to quit. Implementing anti-smoking policies in prisons is difficult in the absence of appropriate legislation.
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Affiliation(s)
- Jean-François Etter
- Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva, Switzerland.
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Thibodeau L, Seal DW, Jorenby DE, Corcoran K, Sosman JM. Perceptions and influences of a state prison smoking ban. JOURNAL OF CORRECTIONAL HEALTH CARE 2012; 18:293-301. [PMID: 22935623 DOI: 10.1177/1078345812456019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prison smoking bans are increasingly common. It is important to consider how those who are incarcerated respond to these bans and to the subsequent development of contraband tobacco markets. Since there are high rates of smoking in individuals who become incarcerated, along with high rates of chronic illnesses that are exacerbated by smoking, it is critical to examine whether there are health promoting changes in perceptions of and intentions toward smoking and other health behaviors that can be maintained on release to the community. Interviews with incarcerated men experiencing a prison smoking ban revealed their responses to being smoke-free, reactions to the presence of contraband smoking, and the influences of this experience on their intentions to smoke following release.
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Affiliation(s)
- Laura Thibodeau
- Department of Medicine, Division of General Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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Should any workplace be exempt from smoke-free law: the Irish experience. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2012; 2012:545483. [PMID: 22693522 PMCID: PMC3368201 DOI: 10.1155/2012/545483] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 03/17/2012] [Accepted: 03/27/2012] [Indexed: 11/21/2022]
Abstract
Background. In 2004, the Irish Government introduced national legislation banning smoking in workplaces; with exemptions for “a place of residence”. This paper summarises three Irish studies of exempted premises; prisons, psychiatric hospitals and nursing homes. Methods. PM2.5 and nicotine were measured in nursing homes and psychiatric hospitals, in addition to ultrafine particles in the hospitals. In the prisons, officers (n = 30) completed exhaled breath Carbon Monoxide (CO) measurements. Questionnaires determined officers' opinion on introducing smoking prohibitions in prisons. Nursing home smoking policies were examined and questionnaires completed by staff regarding workplace secondhand smoke (SHS) exposure. Findings. Ultrafine particle concentrations in psychiatric hospitals averaged 130,000 cm3, approximately 45% higher than Dublin pub (35.5 μg/m3) pre ban. PM2.5 levels in psychiatric hospitals (39.5 μg/m3) were similar to Dublin pubs (35.5 μg/m3) pre ban. In nursing homes permitting smoking, similar PM2.5 levels (33 μg/m3) were measured, with nicotine levels (0.57 μg/m3) four times higher than “non-smoking” nursing homes (0.13 μg/m3). In prisons, 44% of non-smoking officers exhibited exhaled breath CO criteria for light to heavy smokers. Conclusions. With SHS exposure levels in some exempted workplaces similar to Dublin pubs levels pre ban, policies ensuring full protection must be developed and implemented as a right for workers, inmates and patients.
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Richmond RL, Butler TG, Indig D, Wilhelm KA, Archer VA, Wodak AD. The challenges of reducing tobacco use among prisoners. Drug Alcohol Rev 2012; 31:625-30. [PMID: 22449020 DOI: 10.1111/j.1465-3362.2012.00435.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ISSUE The prevalence of smoking among prisoners is exceptionally high and is often comorbid with alcohol and drug problems, mental illness and other health problems. This review paper summarises the literature and available research related to smoking prevalence and smoking cessation initiatives among prisoners and identifies areas of need for further research and intervention. APPROACH This paper highlights three studies conducted in the New South Wales prison system which attempt to address these high rates of smoking including a feasibility study, a focus group study and a randomised controlled trial. KEY FINDINGS The challenges of making systems-level changes to address these high rates of smoking are discussed including a recent National Summit on Tobacco Smoking in Prisons. IMPLICATIONS Dissemination of research findings has assisted in highlighting the importance of tobacco smoking among prisoners and the need to develop culturally and setting appropriate smoking cessation initiatives for prisoners. CONCLUSIONS As one of the most marginalised and socially disadvantaged populations in Australia, prisoners represent an important population to target for smoking cessation programs and interventions. This paper highlights a number of initiatives undertaken to address this problem and suggests directions for the future.
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Affiliation(s)
- Robyn L Richmond
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
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Implementing an indoor smoking ban in prison: enforcement issues and effects on tobacco use, exposure to second-hand smoke and health of inmates. Canadian Journal of Public Health 2011. [PMID: 21913577 DOI: 10.1007/bf03404042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To describe the issues encountered during the implementation of an indoor smoking ban in prison and its effects on self-reported tobacco use, perceived exposure to second-hand smoke (SHS) and perceived health status of inmates in Quebec's provincial correctional facilities. METHODS Quantitative data were obtained from 113 inmates in three provincial correctional facilities in the province of Quebec, Canada. Qualitative data were obtained from 52 inmates and 27 staff members. Participants were recruited through a self-selection process. Particular efforts were made to enrol proportions of men, women, smokers and non-smokers similar to those generally found among correctional populations. RESULTS Despite the indoor smoking ban, 93% of inmates who declared themselves smokers reported using tobacco products inside the correctional facilities and 48% did not report any reduction in their tobacco use. Only 46% of smokers declared having been caught smoking inside the facility, and more than half of them (58%) reported no disciplinary consequences to their smoking. A majority of inmates incarcerated before the implementation of the ban (66%) did not perceive a reduction of their exposure to SHS following the indoor ban. Enforcement issues were encountered during the implementation of the indoor ban, notably because of the amendment made to the original regulation (total smoking ban) and tolerance from smokers in the staff towards indoor smoking. They were also related to perceptions that banning indoor smoking is complex and poses management problems. CONCLUSION This study's findings emphasize the importance of considering organizational and environmental factors when planning the implementation of an indoor smoking ban in correctional facilities.
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Bonevski B, Bowman J, Richmond R, Bryant J, Wye P, Stockings E, Wilhelm K, Butler T, Indig D, Wodak A. Turning of the tide: changing systems to address smoking for people with a mental illness. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/17523281.2011.555073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bishop AJ, Merten MJ. Risk of Comorbid Health Impairment Among Older Male Inmates. JOURNAL OF CORRECTIONAL HEALTH CARE 2011; 17:34-45. [DOI: 10.1177/1078345810385912] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Alex J. Bishop
- Human Development and Family Science Department, Oklahoma State University, Stillwater, OK, USA
| | - Michael J. Merten
- Human Development and Family Science Department, Oklahoma State University, Tulsa, OK, USA
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Eytan A, Haller DM, Wolff H, Cerutti B, Sebo P, Bertrand D, Niveau G. Psychiatric symptoms, psychological distress and somatic comorbidity among remand prisoners in Switzerland. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2011; 34:13-19. [PMID: 21126766 DOI: 10.1016/j.ijlp.2010.11.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The aims of this study were to determine the prevalence of psychiatric symptoms and complaints among remand prisoners in Switzerland and to analyze the relationships between psychiatric symptoms, physical health and substance abuse problems in this population. METHOD The medical files of all detainees attending the prison health service in 2007 were reviewed. Identified health problems were coded using the International Classification of Primary Care (ICPC-2). Descriptive statistics and measures of association were computed. RESULTS A total of 1510 files were analyzed. Several associations between psychological symptoms (anxiety and insomnia) and physical health problems (skin, respiratory and circulatory) were observed. Substance abuse was also frequently associated with somatic health problems. CONCLUSIONS These data provide the first comprehensive description of the mental health of detainees in Switzerland's largest remand prison. Our findings emphasize the need for coordinated health care services in detention settings.
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Affiliation(s)
- Ariel Eytan
- University Hospital of Geneva, Department of Psychiatry, 2 Ch. Petit-Bel-Air 1225 Geneva, Switzerland.
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Abstract
Tobacco-smoking prevalence has been decreasing in many high-income countries, but not in prison. We provide a summary of recent data on smoking in prison (United States, Australia, and Europe), and discuss examples of implemented policies for responding to environmental tobacco smoke (ETS), their health, humanitarian, and ethical aspects. We gathered data through a systematic literature review, and added the authors' ongoing experience in the implementation of smoking policies outside and inside prisons in Australia and Europe. Detainees' smoking prevalence varies between 64 per cent and 91.8 per cent, and can be more than three times as high as in the general population. Few data are available on the prevalence of smoking in women detainees and staff. Policies vary greatly. Bans may either be 'total' or 'partial' (smoking allowed in cells or designated places). A comprehensive policy strategy to reduce ETS needs a harm minimization philosophy, and should include environmental restrictions, information, and support to detainees and staff for smoking cessation, and health staff training in smoking cessation.
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Foley KL, Proescholdbell S, Herndon Malek S, Johnson J. Implementation and enforcement of tobacco bans in two prisons in North Carolina: a qualitative inquiry. JOURNAL OF CORRECTIONAL HEALTH CARE 2010; 16:98-105. [PMID: 20339127 DOI: 10.1177/1078345809356522] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite the national trend that 90% of prisons have smoke-free indoors policies, compliance and enforcement remain barriers to policy success. Key informant interviews about policy compliance and enforcement were conducted with 10 staff and inmates at two North Carolina prison facilities, one with a complete ban (indoors and outdoors) and one with a partial ban (indoors only). Communication of the tobacco bans was consistent and well understood in both facilities. Barriers to compliance and enforcement, especially in the complete ban facility, included policy ''buy in,'' the emerging black market for cigarettes, staff support, and access to nicotine replacement therapy. Despite these barriers, most informants reported that implementation and enforcement of complete bans is possible with adequate communication about the policy and access to cessation therapy.
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Affiliation(s)
- Kristie L Foley
- Medical Humanities, Davidson College, Davidson, North Carolina 28035, USA.
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Chang CC, Huang CL, Chen CY. The Impact of Implementing Smoking Bans Among Incarcerated Substance Users: A Qualitative Study. Eval Health Prof 2010; 33:473-9. [DOI: 10.1177/0163278710369910] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article reports a study evaluating the effects of implementing smoking bans among drug-using prisoners in Taiwan. Seventy-seven new entrants were recruited in May 2008. Six focus groups were conducted in a prison-based treatment center, the only prison with a total smoking ban in Taiwan. All the subjects were male and their average age was 37 years. Three general reactions to the ban were identified across all focus groups: (a) unfair/hypocritical policy; (b) being forced to stop smoking; and (c) finding ways to smoke anyway. Future studies should compare the effects of total versus partial smoking bans among drug abusers in prison to better explore policy options.
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Affiliation(s)
- Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chih-Ling Huang
- Department of Nursing, Chang Jung Christian University, Tainan, Taiwan,
| | - Chih-Yin Chen
- Department of Nursing, Chang Jung Christian University, Tainan, Taiwan
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