Prisoners experience huge health inequalities, and their exceptionally high smoking prevalence (five times the national average) contributes significantly to their high mortality. Since the introduction of smoke-free polices across Her Majesty's Prison and Probation Service (HMPPS) in England and Wales, prisoners are now obliged to abstain from smoking while held in prison. This represents a unique opportunity to promote lifelong cessation in this highly disadvantaged and marginalised group. However, evidence suggests most prisoners intend to resume smoking as soon as possible after release. A systematic review of prison smoke-free polices worldwide concluded that there was a need for new research to identify effective strategies to reduce relapse in these individuals.
The primary objective of this study will be to develop and pilot test the feasibility and acceptability of an intervention to help prevent prisoners relapse to smoking after release. The study will work in accordance with the Medical Research Council (MRC) framework for developing and evaluating complex interventions. The Preventing Relapse tO Smoking among PrisonErs after Release (PROSPER) study consists of three key Phases: 1. Document the support provided to manage nicotine addiction during imprisonment and in the periods immediately before and after release; establish the extent to which prisoners intentionally resume or unintentionally relapse to smoking after release; and obtain views on how relapse might be prevented. 2. Drawing on current literature and findings from Phase 1, develop and design an prototype intervention to prevent smoking relapse after release. 3. To pilot the designed prototype intervention and conduct a process evaluation to inform the development of further work in this area. The research will be carried out in three prisons in the East Midlands. The main duties will include recruitment of participants (HMPPS staff members and prisoners), data collection, data analysis, assist with intervention development and refining related intervention materials/resources, co-facilitate Patient and Public Involvement (PPI) groups, contribute to the ethical application for the pilot intervention, and preparation of manuscripts for peer-review publication.
Study Type
OBSERVATIONAL
Enrollment
40
A prototype intervention will be developed over Phase 1 \& 2 and piloted in Phase 3 of this study.
University of Nottingham, School of Medicine
Nottingham, Please Select, United Kingdom
To develop and pilot test the feasibility and acceptability of an intervention to help prevent prisoners relapse to smoking after release.
Smoking abstinence rates at 1 week, 1 month and 3 months post release, self-reported.
Time frame: 3 years
To document prisoners smoking history to date and levels of nicotine addiction.
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
To document the support provided to manage nicotine addiction during imprisonment and in the periods immediately before and after release.
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
The impact of smoke-free prison policy on prisoners smoking behaviours.
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
To establish the extent to which prisoners intentionally resume or unintentionally relapse to smoking after release (and does their intended behaviour pre-release predict post-release behaviour).
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
To establish the extent to which prisoners relapse to smoking after transfer to an open prison where smoking is permitted in designated areas.
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
To obtain views on triggers to smoking after release (and transfer to an open prison) and how relapse might be prevented.
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
For those prisoners who return to smoking after release, at what point do they resume smoking (in days).
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
After release do prisoners use cessation pharmacotherapy, electronic cigarettes or NHS SSS support, or any other means of preventing relapse.
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
Record and examine other potential predictors (as outlined in the international literature) of relapse to smoking after release from smoke-free prisons, e.g other negative health behaviours.
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
For those prisoners who do return to smoking after release, do they smoke less, the same or more as they previously smoked before entering prison/and or before the prison service went smoke-free.
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
Review of methods of recruitment in prison and community follow-up (to feed into future pilot intervention study).
Phase 1 (Scoping stakeholder interviews/Release prisoner cohort/Reception prisoner cross-sectional)
Time frame: 1 year
To develop, design, and refine an intervention to prevent smoking relapse after release with input from fellow academics, stakeholders and PPI groups.
Phase 2 (Intervention development)
Time frame: 1 year
To develop logic models to map the problem and the prototype intervention.
Phase 2 (Intervention development)
Time frame: 1 year
To assess any barriers and facilitators to the developed intervention.
Phase 3 (Intervention pilot \& Intervention process evaluation)
Time frame: 1 year
To explore any unintended consequences as a result of the intervention.
Phase 3 (Intervention pilot \& Intervention process evaluation)
Time frame: 1 year
To identify aspects of the intervention and delivery that could be improved.
Phase 3 (Intervention pilot \& Intervention process evaluation)
Time frame: 1 year
Explore smoking abstinence rates at 1 week, 1 month and 3 months post release, self-reported and CO validated.
Phase 3 (Intervention pilot \& Intervention process evaluation)
Time frame: 1 year
Explore impact of the intervention on self-reported health, housing, reconviction rates, use of illicit substances in prisoner's post- release.
Phase 3 (Intervention pilot \& Intervention process evaluation)
Time frame: 1 year
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