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