Centre for Health Services Research, The University of Queensland, Brisbane, Australia; Griffith Criminology Institute, Griffith University, Brisbane, Australia.
Griffith Criminology Institute, Griffith University, Brisbane, Australia; Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, United Kingdom; School of Justice, Queensland University of Technology, Brisbane, Australia.
Int J Drug Policy. 2019 Jun;68:9-17. doi: 10.1016/j.drugpo.2019.03.018. Epub 2019 Apr 8.
The prevalence of smoking among people entering prisons is high. Despite increasing adoption of prison smoke-free policies, relapse to smoking after release from prison is nearly universal, and policy to effectively mitigate this is largely absent. Informed by a risk environment framework, we aimed to identify key barriers and facilitators to maintaining smoking abstinence among former smokers released from smoke-free prisons.
Twenty-one people released from smoke-free prisons in Queensland, Australia, were followed up from a larger survey of 114 former prisoners. Semi-structured interviews were used to explore the perceived barriers and facilitators of maintained smoking abstinence.
Identified barriers to continued abstinence included pre-release intention to resume smoking; normalisation of smoking in home or social environments, resumption of smoking as a symbolic act of freedom and resistance from and to a restrictive environment; a perception that smoking provides stress relief to their difficult lives, and the use of tobacco/smoking to cope with cravings experienced on release for illicit substances. A number of interviewees were unable to provide clear reflective reasons for relapse. For those who did manage to remain abstinent for a period of time, identified facilitators included an awareness of the health and financial benefits of smoking abstinence, the use of intrinsic motivation, distraction from nicotine cravings using alternative activities, and social support from family and peers.
Interventions promoting continued smoking abstinence among people exiting smoke-free prisons should focus on targeting the perceived individual- and environmental-level barriers to maintained smoking abstinence while simultaneously promoting perceived facilitators, so as to reduce smoking-related health and economic disparities in this marginalised population.
进入监狱的人群中吸烟现象普遍存在。尽管越来越多的监狱开始实施禁烟政策，但囚犯出狱后几乎都会复吸，而目前缺乏有效的政策来缓解这一问题。本研究以风险环境框架为指导，旨在确定在从无烟监狱释放的前吸烟者中保持吸烟戒断的关键障碍和促进因素。
在对 114 名前囚犯进行的一项更大规模调查中，对 21 名从澳大利亚昆士兰州无烟监狱释放的人员进行了随访。采用半结构化访谈的方法，探讨了维持吸烟戒断的障碍和促进因素。
持续戒断的障碍包括释放前打算复吸、家庭或社会环境中吸烟正常化、将复吸作为一种象征自由的行为和对限制环境的反抗、认为吸烟可以缓解他们艰难生活中的压力，以及用烟草/吸烟来应对释放后对非法物质的渴望。一些受访者无法清楚地说出复吸的原因。对于那些在一段时间内成功保持戒断的人来说，促进因素包括认识到吸烟戒断的健康和经济益处、利用内在动机、通过替代活动分散对尼古丁的渴望、以及来自家人和同伴的社会支持。
促进从无烟监狱释放的人员继续保持吸烟戒断的干预措施应侧重于针对维持吸烟戒断的个体和环境障碍，同时促进可感知的促进因素，以减少这一边缘化人群中与吸烟相关的健康和经济差距。
