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5 Health & Just. 1 (2017)

handle is hein.journals/hlthjs5 and id is 1 raw text is: Puljevie et al. Health and Justice (2017) 5:1 DOI 10.1186/s40352-016-0046-6 Health and Justice STUD PRTOCL Oen Ccssak Extending smoking abstinence after release CrossMak from smoke-free prisons: protocol for a randomised controlled trial Cheneal Puljevi6, Stuart A. Kinnerl'2'3'4'5'6 and Dominique de Andrade' Background Tobacco smoking is a global public health issue, killing approximately six million people annually (World Health Organisation, 2015). It is a major risk factor for many physical disorders such as coronary heart disease, cancer, and strokes (AIHW, 2014a). In Australia, tobacco is re- sponsible for 7.8% of the total burden of disease and injury-making it the greatest single contributor to the burden of disease in the country (Begg et al., 2007). For- tunately, the health benefits of quitting tobacco smoking are both substantial and rapid (Zwar et al. 2014). Despite declining levels of tobacco smoking in Australia's general population (AIHW, 2014b), the prevalence of * Correspondence: c.puljevic@griffith.edu.au Grifft Crmno ogy nsttute, Graffbt Unversty, Brsbane, Austra a Ful lst of author information is available at the end of the article C Springer Open smoking has remained stubbornly high for Australian prisoners-74% of whom smoke (AIHW, 2015), a rate which is five times that in the general population (AIHW, 2014a). One reason for the high prevalence of smoking in prisoners is that groups with a high preva- lence of smoking in the community-such as Indigen- ous people, people with a mental illness, people who inject drugs, and people from socio-economically disad- vantaged backgrounds-are also at increased risk of in- carceration (AIHW, 2013a, 2013b, 2015; Belcher et al. 2006). The high prevalence of tobacco consumption among prisoners contributes significantly to increased age-adjusted mortality rates and years of potential life lost, when compared to the general population (Binswanger et al., 2014; Kinner, Forsyth, et al. 2013; Kinner, Lennox, et al. 2013), and to some of the worst health outcomes out of © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license. and indicate if chanoes were made. Abstract Background: A smoking ban was implemented across all prisons in Queensland, Australia, in May 2014, with the aim of improving the health of prisoners and prison staff. However, relapse to smoking after release from prison is common. Only one previous study, conducted in the United States, has used a randomised design to evaluate an intervention to assist individuals in remaining abstinent from smoking following release from a smoke-free prison. Methods: This paper describes the rationale for and design of a randomised controlled trial of an intervention to extend smoking abstinence in men after release from smoke-free prisons in the state of Queensland, Australia. Participants in the intervention group will receive a brief intervention involving four group sessions of motivational interviewing and cognitive behavioural therapy, initiated 4 weeks prior to release from prison. The comparison group will receive a pamphlet and brief verbal intervention at the time of baseline assessment. Assessment of self-reported, post-release smoking status will be conducted by parole officers at regular parole meetings with the primary outcome measured at 1 month post release. Discussion: The prevalence of smoking and related health harms among people who experience incarceration is extremely high. Effective interventions that result in long-term smoking cessation are needed to reduce existing health disparities in this vulnerable population. Trial registration: Current Controlled Trials ACTRN12616000314426 Keywords: Smoking cessation, Tobacco, Forced abstinence, Incarceration, Re-entry, Randomized controlled trial

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