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Jayes L, Waddingham J, Britton J, Murray R. A Qualitative Study of the Implementation and Continued Delivery of Complete and Partial Smoke-Free Policies Across England's Prison Estate. Nicotine Tob Res 2023; 25:1099-1108. [PMID: 36629042 PMCID: PMC10202636 DOI: 10.1093/ntr/ntac296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/17/2022] [Accepted: 01/10/2023] [Indexed: 01/12/2023]
Abstract
INTRODUCTION In the United Kingdom, smoking among prisoners is up to five times more prevalent than the national average. Between 2015 and 2018, HMPPS introduced a complete smoke-free policy in all closed prisons, and a partial policy permitting smoking only in smoking shelters in open prisons. AIMS AND METHODS This study aimed to explore the views of stakeholders regarding the implementation and continuation of smoke-free policies, including the management of nicotine addiction during imprisonment and after release. Individuals with key strategic and/or operational roles in delivering smoke-free prison policies across England were purposively sampled to complete a semi-structured interview. Twenty-eight interviews were analyzed thematically. RESULTS The smoke-free implementation across the closed prison estate was viewed as a success, though there were reports of reduced availability of smoking cessation support since the roll out. Participants thought the majority of tobacco smokers living in closed prison environments were now using an electronic cigarette, typically as a temporary means to manage nicotine addiction until release. In open prisons the partial policy has been less successful; high rates of smoking resumption on moving from closed to open conditions were reported, with many participants arguing that the open estate should also go completely smoke free. It was envisaged that most prisoners would resume smoking on community release. CONCLUSIONS The smoke-free policies provide a unique opportunity to promote lifelong cessation in this highly disadvantaged group. However more could be done to adopt a consistent smoke-free policy across all prisons, and to support prisoners in quitting smoking and nicotine use during and after imprisonment. IMPLICATIONS Our results identify the urgent need for more work to explore rates and reasons for relapse to smoking on transfer to the open estate and after release. With the majority of smokers in the closed prison estate now using e-cigarettes to manage their nicotine addiction, one way to support long-term tobacco abstinence could be to place greater emphasis on this switching behavior as a way of reducing tobacco-related harm within this population.
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Affiliation(s)
- Leah Jayes
- Institute of Health and Allied Professions, Nottingham Trent University, Clifton Campus, Nottingham NG11 8NS, UK
| | - Jessica Waddingham
- JJR Macleod Centre for Diabetes, Endocrinology and Metabolism, NHS Grampian, Aberdeen, UK
| | - John Britton
- Population and Lifespan Sciences, School of Medicine, The University of Nottingham, Nottingham, UK
| | - Rachael Murray
- Population and Lifespan Sciences, School of Medicine, The University of Nottingham, Nottingham, UK
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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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Puljević C, Segan CJ. Systematic Review of Factors Influencing Smoking Following Release From Smoke-Free Prisons. Nicotine Tob Res 2020; 21:1011-1020. [PMID: 29733380 DOI: 10.1093/ntr/nty088] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/30/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Given the current proliferation of prison smoke-free policies internationally, and the multiple benefits of continued smoking abstinence for correctional populations, improved understanding of factors influencing postrelease smoking abstinence is required to inform support strategies aimed at individuals exiting smoke-free prisons. METHODS We systematically searched health, social science, and criminal justice databases for studies relating to smoking behaviors among people released from smoke-free prisons. Studies were included if: they were published between January 1, 2000 and July 26, 2017; they were published in English; the population was people who were incarcerated or formerly incarcerated in prisons with total smoke-free policies; and the reported outcomes included measures of: (1) prerelease intention to smoke or remain abstinent from smoking following release, (2) smoking relapse or abstinence following release, or (3) quit attempts following postrelease smoking relapse. Both authors independently screened returned citations to assess eligibility and reviewed studies for methodological quality using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies. RESULTS Fifteen of 121 publications were included. The evidence base in this area is small, almost exclusively US-based, and is mostly methodologically weak. Interventions delivered both pre and postrelease, that strengthen intention to quit, integrate with other substance-use treatment, and facilitate social support for quitting may help maintain postrelease smoking abstinence. CONCLUSIONS There is an urgent need for high-quality research to inform interventions to reduce high smoking relapse rates upon release from smoke-free prisons, to extend the multiple benefits of continued smoking abstinence into the community. IMPLICATIONS Interventions designed to help people remain abstinent from tobacco following release from smoke-free prisons are an important opportunity to improve the health, finances, and well-being of this vulnerable population.
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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
| | - Catherine J Segan
- Cancer Council Victoria, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Awooda EM, Shashati DE. Tobacco use among male inmates and their attitudes toward its prevention in Khartoum State: A cross-sectional study. Tob Prev Cessat 2019; 5:25. [PMID: 32411888 PMCID: PMC7205156 DOI: 10.18332/tpc/109784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/01/2019] [Accepted: 06/02/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tobacco use remains the most preventable cause of death and disability, with prisoners being a neglected population of tobacco users. The aim was to determine the prevalence of tobacco use and attitudes toward its prevention among adult male prisoners. METHODS We conducted a descriptive cross-sectional study among 349 adult male inmates from three prisons in Khartoum State. The interview questionnaire included questions related to tobacco use status, type of tobacco used, previous attempts to quit, smoking inside a room, frequency of tobacco use before and after incarceration, and attitude toward its prevention. Chi-squared and paired t-test were used to compare between different variables, with the level of significance set at p≤0.05. RESULTS The majority (69.1%) were in the age group 30-50 years. All of the studied prisoners were tobacco users of which: 43.8% used oral snuff (toombak); 22.1% were cigarette smokers; 30.9% used both cigarette and toombak; 0.6% used cigarette and waterpipe; and 3.2% used cigarette, toombak and waterpipe. Toombak users (alone or with other types of tobacco) were 272 (78%) with the majority (62.4%) dipping 2-5 times per day. There were 96 (57%) cigarette smokers (alone or with other types), and waterpipe users were 12 (3.8%). The majority (74.6%) of cigarette users shared their cell with other toombak users. For the majority (79.6%), the number of cigarettes and snuff dipping per day was directly proportional to the period of incarceration. Almost all (99.1%) prisoners know the harmful effects of tobacco use, and 64.5% had previously attempted to quit. Also, 98% of tobacco users reported a desire to quit and expressed willingness to participate in a tobacco-cessation program. CONCLUSIONS Different patterns and methods of tobacco use were explored, and all the studied prisoners were users. Tobacco use increased after incarceration. The willingness to participate in tobacco-cessation counselling should be met with the implementation of a planned and well-designed prevention program.
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Affiliation(s)
- Elhadi M. Awooda
- Department of Restorative Dentistry, University of Medical Science and Technology, Khartoum, Sudan
| | - Dina E. Shashati
- Department of Restorative Dentistry, University of Medical Science and Technology, Khartoum, Sudan
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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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Young JT, Puljević C, Love AD, Janca EK, Segan CJ, Baird D, Whiffen R, Pappos S, Bell E, Kinner SA. Staying Quit After Release (SQuARe) trial protocol: a randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia. BMJ Open 2019; 9:e027307. [PMID: 31167867 PMCID: PMC6561422 DOI: 10.1136/bmjopen-2018-027307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/25/2019] [Accepted: 04/24/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Smoke-free policies have been introduced in prisons internationally. However, high rates of relapse to smoking after release from prison indicate that these policies typically result in short-term smoking cessation only. These high rates of relapse, combined with a lack of investment in relapse prevention, highlight a missed opportunity to improve the health of a population who smoke tobacco at two to six times the rate of the general population. This paper describes the rationale and design of a randomised controlled trial, testing the effectiveness of a caseworker-delivered intervention promoting smoking cessation among former smokers released from smoke-free prisons in Victoria, Australia. METHODS AND ANALYSIS The multicomponent, brief intervention consists of behavioural counselling, provision of nicotine spray and referral to Quitline and primary care to promote use of government-subsidised smoking cessation pharmacotherapy. The intervention is embedded in routine service delivery and is administered at three time points: one prerelease and two postrelease from prison. Control group participants will receive usual care. Smoking abstinence will be assessed at 1 and 3 months postrelease, and confirmed with carbon monoxide breath testing. Linkage of participant records to survey and routinely collected administrative data will provide further information on postrelease use of health services and prescribed medication. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Corrections Victoria Research Committee, the Victorian Department of Justice Human Research Ethics Committee, the Department of Human Services External Request Evaluation Committee and the University of Melbourne Human Research Ethics Committee. Results will be submitted to major international health-focused journals. In case of success, findings will assist policymakers to implement urgently needed interventions promoting the maintenance of prison-initiated smoking abstinence after release, to reduce the health disparities experienced by this marginalised population. TRIAL REGISTRATION NUMBER ACTRN12618000072213; Pre-results.
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Affiliation(s)
- Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Cheneal Puljević
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
| | - Alexander D Love
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Emilia K Janca
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine J Segan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Donita Baird
- Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | | | - Stan Pappos
- Australian Community Support Organisation, Richmond, Victoria, Australia
| | - Emma Bell
- Australian Community Support Organisation, Richmond, Victoria, Australia
| | - Stuart A Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Mater Research Institute-UQ, The University of Queensland, Brisbane, Queensland, Australia
- Netherlands Institute for the Study of Crime and Law Enforcement, Amsterdam, The Netherlands
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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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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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Spaulding AC, Eldridge GD, Chico CE, Morisseau N, Drobeniuc A, Fils-Aime R, Day C, Hopkins R, Jin X, Chen J, Dolan KA. Smoking in Correctional Settings Worldwide: Prevalence, Bans, and Interventions. Epidemiol Rev 2018; 40:82-95. [PMID: 29746635 PMCID: PMC5982806 DOI: 10.1093/epirev/mxy005] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 02/27/2018] [Indexed: 12/12/2022] Open
Abstract
Smoking tobacco contributes to 11.5% of deaths worldwide and, in some countries, more hospitalizations than alcohol and drugs combined. Globally in 2015, 25% of men and 5% of women smoked. In the United States, a higher proportion of people in prison smoke than do community-dwelling individuals. To determine smoking prevalence in prisons worldwide, we systematically reviewed the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines; we also examined whether prisons banned smoking or treated smokers. We searched databases for articles published between 2012 and 2016 and located 85 relevant articles with data representing 73.5% of all incarcerated persons from 50 countries. In 35 of 36 nations (97%) with published prevalence data, smoking for the incarcerated exceeded community rates 1.04- to 62.6-fold. Taking a conservative estimate of a 2-fold increase, we estimated that, globally, 14.5 million male and 26,000 female smokers pass through prisons annually. Prison authorities’ responses include permitting, prohibiting, or treating tobacco use. Bans may temporarily improve health and reduce in-prison health care costs but have negligible effect after prison release. Evidence-based interventions for smoking cessation effective outside prisons are effective inside; effects persist after release. Because smoking prevalence is heightened in prisons, offering evidence-based interventions to nearly 15 million smokers passing through yearly would improve global health.
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Affiliation(s)
- Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Cynthia E Chico
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Nancy Morisseau
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ana Drobeniuc
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Rebecca Fils-Aime
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Carolyn Day
- Discipline of Addiction Medicine, Central Clinical School, University of Sydney, New South Wales, Australia
| | - Robyn Hopkins
- Department of the Attorney-General and Justice, Northern Territory Correctional Services, Darwin, Australia
| | - Xingzhong Jin
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Junyu Chen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kate A Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Baldwin A, Sobolewska A, Capper T. Pregnant in prison: An integrative literature review. Women Birth 2018; 33:41-50. [PMID: 30559007 DOI: 10.1016/j.wombi.2018.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 10/29/2018] [Accepted: 12/03/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pregnant women in prisons are recognised as a marginalised group. However, there is a limited understanding of the women's unique maternity needs and how correctional institutions and maternity service providers respond to these needs. AIM The aims of the review are threefold. METHOD An integrative literature review was undertaken. A comprehensive search strategy using seven electronic databases resulted in the retrieval of 363 articles. Of them, 32 peer-reviewed studies met the final selection criteria and were included in this review which utilised the Critical Appraisal Skills Program tools and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. Thematic analysis identified universal themes. FINDINGS Three dominant themes emerged related to the experience of pregnant women in prison: (1) risks and vulnerability factors; (2) prison enablers and supports; and (3) prison barriers. Extant research on risks and vulnerability factors is disproportionate to research examining how prisons can enable or obstruct responding to the women's perinatal needs. Limited research on the midwifery support available to the women in prison is available. Significantly, only two out of 32 reviewed papers include research directly conducted with the pregnant women in prison. CONCLUSION Pregnant women in prisons have complex needs. More research is required to understand how prisons can enhance the pregnancy experience by engaging pregnant women in prisons as research participants.
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Affiliation(s)
- Adele Baldwin
- School of Nursing, Midwifery and Social Sciences, CQUniversity, 6 Finsbury Place, Townsville, Queensland, 4810, Australia.
| | - Agnieszka Sobolewska
- School of Nursing, Midwifery and Social Sciences, CQUniversity, 160 Ann St, Brisbane City, QLD, 4000, Australia
| | - Tanya Capper
- School of Nursing, Midwifery and Social Sciences, CQUniversity, 160 Ann St, Brisbane City, QLD, 4000, Australia
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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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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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13
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Robinson A, Sweeting H, Hunt K. UK news media representations of smoking, smoking policies and tobacco bans in prisons. Tob Control 2018; 27:622-630. [PMID: 29459388 PMCID: PMC6252368 DOI: 10.1136/tobaccocontrol-2017-053868] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Prisoner smoking rates remain high, resulting in secondhand smoke exposures for prison staff and non-smoker prisoners. Several jurisdictions have introduced prison smoking bans with little evidence of resulting disorder. Successful implementation of such bans requires staff support. As news media representations of health and other issues shape public views and as prison smoking bans are being introduced in the UK, we conducted content analysis of UK news media to explore representations of smoking in prisons and smoke-free prisons. METHODS We searched 64 national and local newspapers and 5 broadcast media published over 17 months during 2015-2016, and conducted thematic analysis of relevant coverage in 106 articles/broadcasts. RESULTS Coverage was relatively infrequent and lacked in-depth engagement with the issues. It tended to reinforce a negative view of prisoners, avoid explicit concern for prisoner or prison staff health and largely ignore the health gains of smoke-free policies. Most coverage failed to discuss appropriate responses or support for cessation in the prison context, or factors associated with high prisoner smoking rates. Half the articles/broadcasts included coverage suggesting smoke-free prisons might lead to unrest or instability. CONCLUSIONS Negative news media representations of prisoners and prison smoking bans may impact key stakeholders' views (eg, prison staff, policy-makers) on the introduction of smoke-free prison policies. Policy-makers' communications when engaging in discussion around smoke-free prison policies should draw on the generally smooth transitions to smoke-free prisons to date, and on evidence on health benefits of smoke-free environments and smoking cessation.
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Affiliation(s)
- Amy Robinson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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14
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Puljević C, de Andrade D, Carroll M, Spittal MJ, Kinner SA. Use of prescribed smoking cessation pharmacotherapy following release from prison: a prospective data linkage study. Tob Control 2017; 27:474-478. [PMID: 28848000 DOI: 10.1136/tobaccocontrol-2017-053743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/20/2017] [Accepted: 08/02/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND A significant proportion of people who cycle through prisons express a desire to quit smoking, yet smoking rates in this population are two to four times higher than in the general community. Smoking cessation pharmacotherapy (SCP) is an important component of evidence-based cessation support, yet no studies have examined use of this pharmacotherapy after release from prison. METHODS We linked data from a survey of 971 smokers who were within 8 weeks of release from prison in Queensland, Australia, with federal Pharmaceutical Benefits Scheme (PBS) records for the 2 years after release, to identify subsidised use of SCP (varenicline, bupropion and nicotine patches). We used Cox proportional hazards regression to identify independent predictors of SCP use. FINDINGS According to PBS data, 86 participants (8.9%) accessed SCP in the 2 years following release from prison. Participants who were aged 25 years or older (HR 2.51, 95% CI 1.19 to 5.31), employed before prison (HR 1.93, 95% CI 1.14 to 3.28), highly nicotine dependent at baseline (HR 2.21, 95% CI 1.23 to 3.97) and using non-psychotropic medications in prison (HR 2.29, 95% CI 1.24 to 4.22) were more likely to use subsidised SCP during follow-up. CONCLUSION Despite a very high rate of tobacco use among people cycling through prisons and the very low cost of (subsidised) SCP in Australia, few ex-prisoners obtain pharmaceutical assistance with quitting smoking. Policy attention needs to focus on supporting former prisoners to access SCP, to reduce the high rate of tobacco-related morbidity and mortality in this profoundly marginalised population.
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Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, 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
| | - Megan Carroll
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Sydney, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia.,Mater Research Institute-UQ, University of Queensland, Queensland, Australia
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15
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Bonevski B, Borland R, Paul CL, Richmond RL, Farrell M, Baker A, Gartner CE, Lawn S, Thomas DP, Walker N. No smoker left behind: it's time to tackle tobacco in Australian priority populations. Med J Aust 2017; 207:141-142. [PMID: 28814207 DOI: 10.5694/mja16.01425] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/26/2017] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | | | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW
| | | | | | - Sharon Lawn
- Flinders Human Behaviour and Health Research Unit, Flinders University, Adelaide, SA
| | | | - Natalie Walker
- National Institute for Health Innovation, University of Auckland, Auckland, NZ
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16
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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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