How can we reduce smoking rates in the

prison setting?

Jenny Wares & Elisabeth Smart

Scottish Committee of the Faculty of Public Health Conference - November 2014

Background

•Principal cause of preventable illness and premature death

•Smoking prevalence in prisons is higher than the general population

•Estimates of prevalence range from 50% to 83%(1)

(1) Binswanger I., Carson E., Krueger P., Mueller S., Steiner J., Sabol W. Prison tobacco control policies and deaths from smoking in United States prisons: population based retrospective analysis. BMJ, 2014; 349 (aug04 3): g4542.

Interventions• Smoking and/or tobacco ban

• Tobacco coordinator

• Smoking cessation services:▫brief interventions ▫individual support and advice▫nicotine replacement therapy ▫acupuncture ▫smoking cessation courses▫incentives such as increased access to

physical exercise

Smoking bans

•Implemented in countries such as the United States, Canada and New Zealand

•Variability in ban implementation:▫complete bans▫partial bans (indoor or communal areas)

Issues

• Implications for health▫Reductions in smoking related deaths

•Reductions in exposure to second-hand smoke▫Improved air quality▫Smoke-free environment supports smoking

cessation

•Restricts autonomy

•Sustainability post-release

• Implementation and enforcement

Summary

•Key public health priority

•Variety of possible approaches

•Tailored services required

•Coordination required between all sections of the criminal justice system