Smoking cessation in smoke-free prisons: a grounded theory study

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.