Sheila Duffy: Smoke-free prisons will change attitudes and protect health

Almost three-quarters of prisoners in Scotland smoke, more than three times the rate of smokers within the overall population. A number of factors contribute to the high smoking rates in Scotland's prisons. People coming into prison are much more likely to have experienced poverty, and mental health problems, to have low levels of education and literacy, and they are much more likely to have current substance use disorders.

HMP Addiewell Prison

In addition, smoking is still embedded in prison culture, with tobacco sometimes being used as a currency. Research by the Scottish Prison Service shows an interesting link between the number of times someone is remanded in custody, and the likelihood of their being a smoker. Of those who had never previously been sentenced to prison, around 60 per cent were smokers. 74 per cent of those remanded 1-5 times, 86 per cent of those remanded 6-10 times, and 89 per cent of those who had been in prison over 10 times were smokers. Yet as with the general population, the majority of people in prison who smoke say that they would prefer not to be smokers.

Throughout Scotland, most enclosed public places became smoke-free by law in March 2006. While the law did not apply to prisons, Scottish Prison Rules were amended at that time to restrict smoking to certain areas, to prison cells and outdoor recreation areas. There are also designated no-smoking units in some facilities, in 
particular youth offenders’ settings and mother and baby units.

In practice, the majority of prisoners can smoke in their cells provided the cell has been designated as a smoking cell by the governor. On admission to custody, prisoners are routinely asked for their smoking preference with a view to minimising the incidence of non-smokers having to share accommodation with smokers. However these preferences cannot always be met.

According to the 2015 Prisoners Survey, a quarter of prisoners (26 per cent) reported that they shared a cell with a smoker, down from 34 per cent in 2013 and 46 per cent in 2011. Because smoking rates are so high amongst prisoners, levels of tobacco smoke in some indoor prison areas are also likely to be high. Breathing in tobacco smoke is known to be harmful to health, and there is no safe level of exposure.

Smoke-free prison facilities are becoming increasingly common throughout the world. Recent research in England measured the air quality in prisons and concluded that “smoking in prisons therefore represents a significant health hazard to prisoners and staff”.

Since 2005, the Scottish Government has been committed to working towards a smoke-free prison service, and in the five-year national strategy published in 2013, took an action to “work in partnership with the Scottish Prison Service and local NHS Boards to have plans in place by 2015 that set out how indoor smoke-free prison facilities will be delivered”. The Cabinet Secretary for Justice reported in February 2016 that an options paper was being prepared which would inform an action plan and timescales for the introduction of indoor smoke-free prison facilities in Scotland. In this we will join a growing movement world-wide.

New Zealand was the first country in the world to implement a comprehensive smoke-free prisons policy in July 2011. Their experience suggests that prisons can become smoke-free without serious adverse effects provided that there is good preparation, good support for smokers, and that the policy is comprehensive. Smoking is prohibited within federal prisons in both the United States and Canada, and the majority of Australian states and territories have introduced some level of smoke-free or tobacco-free policy. Within Europe, the Isle of Man prison went smoke-free in 2008 and Les Nicolles prison on Guernsey went smoke-free in January 2013.

Like the Scottish Government, the Westminster government and the Welsh Assembly are working towards implementing a phased roll-out. This began with implementation at all open prisons in England and Wales in October 2015, followed by a phased implementation of smoke-free policy for all prisons. The Northern Ireland Department of Justice has set out no current plans to change its rules, meaning smoking is expected to continue in prison cells within the jurisdiction.

When Scotland’s indoor public spaces became smoke-free ten years ago, much of the media comment was about how damaging tobacco smoke is to people’s lungs and circulatory systems, and how it increases the risks of developing cancer. Tobacco smoke is no less dangerous today, and if properly implemented, having smoke-free Scottish prison buildings will go a long way towards changing attitudes to tobacco, and protecting people’s health.

• Sheila Duffy, Chief Executive ASH Scotland