Smoking in prisons: the need for effective and acceptable interventions.

Area of Science:

• Public Health
• Criminology
• Health Policy

Background:

• Tobacco-smoking prevalence is declining in high-income nations but remains elevated within correctional facilities.
• Prevalence rates among detainees are significantly higher, often exceeding 64% and potentially three times that of the general population.
• Limited data exists on smoking prevalence among female detainees and prison staff.

Purpose of the Study:

• To summarize current data on smoking prevalence in U.S., Australian, and European prisons.
• To analyze implemented policies for managing environmental tobacco smoke (ETS) within prisons.
• To discuss the health, humanitarian, and ethical implications of these policies.

Main Methods:

• Systematic literature review of recent data on prison smoking.
• Inclusion of authors' practical experience with smoking policy implementation in Australian and European prisons.
• Analysis of policy variations, including total or partial smoking bans.

Main Results:

• Detainee smoking rates range from 64% to 91.8%, substantially higher than the general population.
• Significant variation exists in implemented smoking policies across jurisdictions.
• Policies range from total smoking bans to partial measures allowing smoking in designated areas.

Conclusions:

• A harm minimization approach is essential for comprehensive ETS reduction strategies in prisons.
• Effective policies require environmental restrictions, accessible cessation support for detainees and staff, and training for health personnel.
• Addressing the high prevalence of smoking in prisons is critical for improving health outcomes and ethical standards.