Predictors of opinions on prison smoking bans: Analyses of survey data from Scottish staff and prisoners
Helen Sweeting 1  
Sean Semple 2
Ashley Brown 2
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MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
Institute for Social Marketing, University of Stirling, Stirling, United Kingdom
Helen Sweeting   

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
Publish date: 2019-06-04
Tob. Induc. Dis. 2019;17(June):47
Policy-makers and practitioners need to understand characteristics associated with support for smoking restrictions to identify both potential allies and groups requiring particular support/targeted communication in the face of restrictions. Using data from prison staff and prisoners, we explored the structure and correlates of opinions relating to prison smoking bans.

Questionnaires were completed by staff (online, N=1,271; 27% return) and prisoners (paper-based; N=2,512; 34%) in all 15 Scottish prisons in 2016/17. At that time, prisoners could smoke in their own cells and during outdoor recreation; staff smoking was prohibited anywhere on prison grounds. Staff and prisoner questionnaires included identical/very similar questions around opinions on smoking in prisons and prison smoking bans, own smoking behaviour, health and sociodemographic details. We also measured fine particulate matter (PM2.5) as a proxy for second-hand smoke (SHS) levels in every prison.

Principal components analysis identified two factors: ‘Positive about bans’ (higher scores among staff) and ‘Bans will be difficult’ (higher scores among prisoners). In multivariate analyses, ‘Positive about bans’ was associated with: not smoking (both staff and prisoners); better general health, more respiratory symptoms and working in an operational role among staff; and no asthma, more sensory symptoms, higher educational level and status/release date among prisoners; ‘Bans will be difficult’, was associated with fewer sensory symptoms and lower prison SHS levels among staff, and being a smoker among prisoners. In smoker-only analyses, heavier smokers were less positive about bans and more likely to believe bans will be difficult.

Results suggest it is possible to be positive about prison smoking bans whilst also recognising and/or concerned about potential operational difficulties, and that these opinions are associated with several characteristics additional to smoker status. Support for future prison bans may be stronger if staff have access to objective SHS exposure measures.

We are grateful to the staff and prisoners who completed the surveys and staff at the Scottish Prison Service and at the two non-SPS-run prisons (HMP Addiewell and HMP Kilmarnock) who assisted with the study, including the air quality measurements. We thank colleagues at MRC/CSO Social and Public Health Sciences Unit, Public Health Research Facility for help with data management and input (in particular D. Walker, K. Campbell and M. Tolan). We gratefully acknowledge the contribution of our TIPs co-investigators to the overall design of the study (L. Bauld, K. Boyd, P. Conaglen, P. Craig, D. Eadie, A. Leyland and J. Pell). We particularly thank S. Corbett, L. Dorward, R. Parker and members of the SPS Research Advisory Group for their helpful input during the design and conduct of this research.
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
The TIPs study was funded by the National Institute for Health Research Public Health Research Programme (project number 15/55/44). The authors acknowledge funding from the Medical Research Council (MC_UU12017/12 and MC_PC_13027 to ED) and Chief Scientist Office (SPHSU12). The views and opinions expressed in this work are those of the authors and do not necessarily reflect those of the Public Health Programme, NIHR, NHS or the Department of Health.
H.S., S.S. and E.D. are Co-Investigators and K.H. Principal Investigator of the Tobacco In Prisons study (TIPs) and therefore all contributed to the overall design, methods and materials of the study. H.S. and K.H. managed the staff and prisoner surveys and S.S. led on the secondhand smoke measurements. H.S. conceived and conducted the analyses presented here and first-drafted the paper. All authors contributed to subsequent drafts and approved submission.
Not commissioned; externally peer reviewed.
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