Criminal Justice and Prisons

(Funded by Cancer Research UK)

This study aimed to explore the role of e-cigarettes in the implementation of smoke-free prisons and ongoing management of prisoner populations. The study involved interviews with staff and people in custody (prisoners) to better understand perspectives and experiences of e-cigarettes in the prison setting before and after the implementation of a smoking ban. The study also analysed prisoner spending on items such as tobacco, e-cigarettes and food and drink, against critical stages in the implementation and routine management of smoke-free prisons. This study extended to other ongoing research (the Tobacco in Prisons Study, ‘TIPs’) which was conducted to inform and evaluate the implementation of a smoking ban in Scotland’s prisons.

ISM Staff: Kate Hunt, Ashley Brown, Rachel O’Donnell, Douglas Eadie, Richard Purves, Catherine Best and Allison Ford

External: Helen Sweeting, University of Glasgow; Linda Bauld, University of Edinburgh; Scottish Prison Service

(Funded by the National Institute of Health Research)

This project began in 2016 and it examined the implementation of a new policy - a total smoking ban in Scottish prisons from 30th November 2018. To our knowledge, our study was the first to evaluate the introduction of a prison smoking ban using data collected throughout a prison system over time. The first Phase of the project (Phase 1) began well in advance of the policy change, to understand how people living and working within Scotland’s prisons felt about tobacco use and a potential smoking ban. We also measured levels of second-hand smoke in prisons and talked to people who used and provided smoking cessation support. Phase 2 began in July 2017, after the announcement that Scotland’s prisons would become smokefree from 30th November 2018, and was designed to understand if and how things changed in the lead up to the implementation of a smoking ban. Phase 3 was designed to evaluate the impact of the implementation of a smoking ban.

The study used a range of methods across the three phases, to examine the process and outcomes of the removal of tobacco from Scotland’s prison system. Specifically, objective measurement of second-hand smoke exposures in all 15 Scottish prisons; online staff surveys and paper prisoner questionnaires; interviews and/or focus groups with prison and healthcare staff and people in custody (prisoners); interviews with personnel in other countries which introduced prison smoking bans; analysis of routinely collected data; and health economic modelling. The results were shared on an ongoing basis with key stakeholders to inform decision-making and communication strategies in respect of the implementation of a prison smoking ban in Scotland. This study was conducted in partnership with the University of Glasgow, and with the Scottish Prison Service.

ISM Staff: Kate Hunt (PI), Sean Semple, Ashley Brown, Douglas Eadie, Richard Purves, Andrea Mohan and Ruaraidh Dobson.

(Commissioned by the Department of Health) 

This project aimed to develop and share knowledge and learning in relation to smoking cessation in prisons and broadening out to other organisations across the criminal justice system that also had the potential to contribute to quitting and to generic services. It encompassed broad target groups such as offenders, families and staff within the criminal justice system. It aimed to develop functioning systems for provision of support and care pathways, in prisons, on release, across the CJS, and into the community, which would result in enhanced engagement and quit rates. A Regional Criminal Justice System (CJS) Tobacco Control Coordinator was appointed to look toward the organisational/systems perspectives across prisons, probation services, police and courts in relation to tobacco control and stop smoking support and treatment, and full process and outcomes evaluation were conducted. This was part of an overall bid coordinated by UKCTCS covering six settings in all.

CTCR Staff: Susan MacAskill, Douglas Eadie and Jennifer McKell

Publications:
Eadie D, MacAskill S, McKell J and Baybutt M (2012). Barriers and facilitators to a criminal justice tobacco control coordinator: An innovative approach to supporting smoking cessation among offenders. Addiction, 107(Suppl2): 26-38.

(Commissioned by NHS Health Scotland) 

Alcohol problems are a major and growing public health problem in Scotland with the relationship between alcohol and crime, in particular violent crime, increasingly being recognised. This study was part of a wider Scottish Government funded alcohol research programme in criminal justice settings which also included a pilot of the delivery of alcohol brief interventions and a scoping study of alcohol interventions in community justice settings. It was anticipated that the study findings would inform broader health service development such as the integration of prison health care into the NHS and the update of core alcohol treatment and support services. These developments were set within a policy and practice context which acknowledged alcohol problems in the population and increasingly so the alcohol problem in offenders, along with the importance of applying a person-centred, recovery orientated approach underpinned by the NHS commitment to quality of services.

The aim of this study was to undertake a needs assessment of alcohol problems experienced by prisoners and provide recommendations for service improvement including a model of care. Key elements included:

• a rapid review of the relevant literature on effective interventions
• a report on the epidemiology of alcohol problems experienced by prisoners in Scotland
• an assessment of alcohol problems among offenders within an individual prison using the AUDIT screening tool
• mapping current models of care in the Scottish Prison Service and the interface with community care models
• exploration of attitudes towards the delivery and effectiveness of current alcohol interventions through qualitative interviews in a prison case study
• a gap analysis between current service provision, best practice, effective interventions and national care standards for substance misuse.

The study involved both quantitative and qualitative information being gathered through primary data collection and document retrieval and analysis.

The final report was launched at the Alcohol and Offenders Event, Edinburgh, 8th February 2011. 

ISM Staff: Susan MacAskill, Douglas Eadie and Oona Brooks (left 2010)

Collaborators: Tessa Parkes (lead), Ruth Jepson, Iain Atherton, Lawrence Doi and Stephen McGhee, Faculty of Health Sciences and Sport, University of Stirling

(Commissioned by Offender Health at the Department of Health)

The study evaluated the Department of Health's disease prevention and health promotion policies and programme initiatives for tackling blood-borne viruses in prisons in England and Wales. Blood-borne viruses (BBVs) can cause serious illness and death. In 2007/2008, a series of policy and programme initiatives were instigated in prisons in England and Wales to prevent and control BBVs.

The study was designed to assess: the impact of the disinfectant tablets programme; the impact of the Hepatitis B Key Performance Indicators (KPIs); the impact of BBV programme elements on voluntary uptake of tests among prisoners; and, the response to and impact of exposure to disease prevention and health promotion materials. In addition, the study aimed to: identify enabling factors and barriers which have an effect on implementation of the relevant policies and programme initiatives; examine interactive effects between varying prevention and screening interventions and health promotion initiatives; and identify best practice and provide practical recommendations for future service and policy development, as well as identification of further research needs.

A combination of qualitative and qualitative data collection was used as the research aimed both to gain top level information across all prisons, and to explore in-depth implementation and impact in a select number of case study prisons. Process evaluation was a key element, as well as identifying and quantifying outcomes where possible. This gave important insights into ‘why' and ‘how' the impacts occurred and helped develop key learning for best practice in BBV prevention and health promotion.

Main data collection stages were:

• Mapping - Mapping BBV related activity across all relevant prisons across the key areas of enquiry.
• Prison Case Studies - In-depth examination of key implementation activities and impact issues in eight selected prisons, including interviews with staff and prisoners.

ISM Staff: Susan MacAskill, Oona Brooks (left 2010), Douglas Eadie and Martine Stead

Collaborator: Michelle Baybutt from the Healthy Settings Development Unit, School of Public Health and Clinical Sciences, University of Central Lancashire