Title: Best Practice for Smoking Cessation in Prisons: Take Your Partners and Other Issues
1Best Practice for Smoking Cessation in
PrisonsTake Your Partners and Other Issues
- Susan MacAskill
- Institute for Social Marketing,
- University of Stirling and the Open University
- Paul Hayton
- Healthy Settings Development Unit
- University of Central Lancashire
ISM Institute for Social Marketing
2The Wider Context
- Developing smoking cessation in prison settings
- Positive national policy environment
- General quit support
- White Paper Choosing Health
- Access to NRT for low income groups
- Development of wider Tobacco Control
- Smoke free workplace
- Public places
- Prison settings, health care development and
smoking cessation - Health care management gt PCTs
- PSOs e.g. PSO 3200 health improvement
- Prisoner demand
3Smoking Cessation Highlights 2003-2006
Piloting showed promising results Acquitted
Toolkit produced 8 Training Seminars brought
together NHS and prison staff to share
expertise Special funding pump primed the
initiative to buy NRT. Now mainstreamed
Mapping exercise of provision Evaluation in
NW prisons reported early 2006 White paper
considers prisons in smoke free areas debate
New PSO by Xmas 2006 (Reports on Prison Health
website)
4Careful Planning Whole Prison Approach
5What support programme?
- Group AND / OR 1-1?
- What NRT?
- Who will deliver the support?
- Prison based staff or external services
- Other support available?
- PE? Acupuncture?
6- What happens in individual
- prisons?
- Stop smoking interventions?
- No smoking policies?
- Additional approaches to enhance quitting?
- PCT staffing enhancing health promotion?
- Health promotion work groups?
- Often individual champions soldiering on
7- SO .
- Who are the key Partners?
- Why and How work as Partners?
-
8- First
- Prisoners
- Key focus
- Want to quit
- Mutual support of quitters
- (also important inequality targets)
9- Prisoners
- Providers of quit support programmes
- Prison Health Care
- Other staff potentially supporting
- Pharmacy
- Physical education
- Residential
- ??
- External cessation specialists
- Direct providers
- Trainers
- On-going support
-
10Who are the Key Partners?
PCTs Stop Smoking Specialists
Prison Health care
Prisoners
General prison staff
11- Prisoners
- Providers of quit support programmes
- Pharmacological support
- Essential part of programme (security
limitations) - NRT clear patches lozenges
- Prescribing (MO?)
- Pharmacy
- Pharmaceutical company
- Plan process
- Type / brand
- Ordering / budgets / delivery
- Dispensing
- Structured dosage sequence
12Who are the Key Partners?
PCTs Stop Smoking Specialists
NRT suppliers
Prison Health care
Prison Pharmacy
Prisoners
General prison staff
13- Prisoners
- Providers of quit support programmes
- Pharmacological support
- Prison staff stakeholders
- Senior management
- Committees working groups
- Health improvement
- Health safety
- Relevant departments e.g. Physical education,
CARATS - General staff
- Support the intervention
- Wider tobacco control environment
- Support prisoners in attending
14Who are the Key Partners?
PCTs Stop Smoking Specialists
NRT suppliers
Prison Senior Management
Prison Health care
Prison Pharmacy
Health Safety/ Health improvement
Prisoners
General prison staff
15- Prisoners
- Providers of quit support programmes
- Pharmacological support
- Prison staff stakeholders
- PCTs
- Health Care management
- Stop smoking specialists
- Public stop smoking services
- Staff quitting
- Released prisoners
- Families
16- Prisoners
- Providers of quit support programmes
- Pharmacological support
- Prison staff stakeholders
- PCTs
- Policy makers
- National / regional
- Quitting support / targets
- Smoke free places / ETS
- Prison networks
17Who are the Key Partners?
PCTs Stop Smoking Specialists
NRT suppliers
National policy makers Regional leads
Prison Senior Management
Prison Health care
Prison Pharmacy
Prison networks
Health Safety/ Health Improvement
Prisoners
General prison staff
Stop smoking services for public
18- Mutual benefits /
- selling points
- PCTs
- Contribute to quit targets
- Reduced health costs from smoke illnesses
- Prison management
- Contribute to PSO 3200 requirements
- Health in workplace issues / reduced litigation
- Smoke free areas
- Cleaner areas
- Reduced surveillance for tobacco black market
19- Mutual benefits /
- selling points
- Providers of services
- Satisfying (although challenging!)
- Role development
- Prisoners
- Health benefits
- Financial benefits
- Personal achievement
- Freedom
- Optimism and future development
20No more bad chest, feel fitter, more money to
spend onmyself. I feel good about this
achievement.(Prisoner)But a lot of them seem
to want to achieve something while they are in
here and that is a big achievement to
them.(Prison Health Care)In terms of meeting
the smoking cessation targets, the Health
Inequality targets, and the targets outlined
within the Cancer Plan, it's been crucial. The
actual success rates in terms of the work have
been much higher than in our general work in the
community. Prisoners are just as likely to
want to give up smoking. (Smoking Cessation
Services)
21- Making it work?
- Meet
- Communicate
- Reward show achievements
- Planning
- Implementation
- Feedback
- Future developments
22Take your Partners
Productive Cessation Interventions
23Take your PartnerExercise
Productive Cessation Interventions sharing
examples and ideas in our group regarding best
practice in prisons
24- Checklist
- Effective partnerships
- A range of cessation delivery models
- Protected staff time and role development
- Clear record keeping
- Assessing and exploiting the expressed desire to
quit - Ring-fenced or clearly identified NRT budgets
- Straightforward NRT prescribing and dispensing
- Staff training and on-going support
- Additional support approaches
- Care Pathways for transfer and release
- Wider tobacco control interventions
- Awareness and anticipation of relevant
legislation and guidance
25Physical and Financial Benefits
And it made me think, God you know Im just
going to work all week just so I can smoke myself
to death, yknow?
Well I feel healthier Im not wheezing anymore
and I actually want to start exercising this
weekend
Ive decided to use my tobacco money to buy
meself a pair of trainers then do some jogging
and stuff like that
26Emotional Benefits
Big cheesy grin, yknow what I mean?
It does feel good being yourself. And it gets
that easy you get the people asking you, Ah do
you want a cigarette? Nah, Im a non-smoker,
just saying that
No more bad chest, feel fitter, more money to
spend on myself. I feel good about this
achievement
27Participation Benefits
We sit down and talk about how we got on
Put theirselves out for us. Were gonna, yknow,
try a bit harder for them
Its a bit of support in the group So if he
has a cigarette and hes telling anybody he
hasnt, everybody knows