About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline

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'

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.

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

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.

Short-term subscription options include 24 hours, 48 hours, or 1 week to HeinOnline.

Contact us for annual subscription options:

Already a HeinOnline Subscriber?

profiles profiles most