Weng Xue, Ma Emily Ching, Song Chu Yu, Lee Jung Jae, Tong Henry Sau Chai, Lai Vienna Wai Yin, Lam Tai Hing, Wang Man Ping
Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China.
School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China.
Tob Induc Dis. 2024 Feb 19;22. doi: 10.18332/tid/183604. eCollection 2024.
Smoking prevalence among people in custody (PIC) is extremely high, and prison-based smoking cessation interventions are needed. The study explored the quitting experiences of PIC who participated in the 'Quit to Win' contest (QTW).
This qualitative study, conducted from 2019 to 2021 in two Hong Kong prisons, included semi-structured individual interviews with 26 PIC (13 men and 13 women) who were participants in QTW and two correctional staff who coordinated QTW. A semi-structured interview guide with open-ended questions was developed to examine multilevel factors that promote or impede smoking cessation in prisons. Maximum variation sampling was used to ensure a diverse range of social, demographic, and smoking profiles. Data were managed and analyzed using thematic analysis.
Two themes were identified from the data: 1) quitting in prison: barriers and facilitators; and 2) QTW in prison: a trigger for behavior change. Barriers (i.e. stress, boredom, isolation, lack of self-autonomy, nicotine dependence and lack of cessation medication, barriers to moving to a different wing) and facilitators (i.e. concerns about health, money savings, and the smoke-free wing) that impeded or supported smoking cessation during incarceration were identified. QTW provided health education, quitting incentives, and social support that helped PIC overcome the barriers of quitting by serving as a trigger for behavior change. Notably, social visits with family were identified as key drivers of PIC's quitting success, whereas their suspension during the COVID-19 pandemic disincentivized their abstinence.
This study introduced the QTW contest to prisons and provided qualitative evidence on the multilevel factors promoting or impeding smoking cessation in prison. QTW helped PIC overcome the barriers of quitting by serving as a trigger for behavior change. Future prison-based interventions should leverage social support, enhance stress-coping skills, facilitate access to pharmacotherapy, and collaborate with correctional services agencies.
在押人员中的吸烟率极高，因此需要开展基于监狱的戒烟干预措施。本研究探讨了参与“戒烟赢奖励”竞赛（QTW）的在押人员的戒烟经历。
这项定性研究于2019年至2021年在香港的两所监狱进行，包括对26名参与QTW的在押人员（13名男性和13名女性）以及两名协调QTW的惩教人员进行半结构化的个人访谈。制定了一份带有开放式问题的半结构化访谈指南，以研究促进或阻碍监狱内戒烟的多层次因素。采用最大差异抽样法以确保涵盖广泛的社会、人口统计学和吸烟情况。使用主题分析法对数据进行管理和分析。
从数据中识别出两个主题：1）在监狱中戒烟：障碍与促进因素；2）监狱中的QTW：行为改变的触发因素。确定了在监禁期间阻碍或支持戒烟的障碍（即压力、无聊、孤独、缺乏自主、尼古丁依赖和缺乏戒烟药物、转至不同监区的障碍）和促进因素（即对健康的担忧、节省金钱以及无烟监区）。QTW提供了健康教育、戒烟激励措施和社会支持，通过作为行为改变的触发因素，帮助在押人员克服戒烟障碍。值得注意的是，与家人的社会探访被确定为在押人员戒烟成功的关键驱动因素，而在新冠疫情期间暂停此类探访则削弱了他们的戒烟动力。
本研究将QTW竞赛引入监狱，并提供了关于促进或阻碍监狱内戒烟的多层次因素的定性证据。QTW通过作为行为改变的触发因素，帮助在押人员克服戒烟障碍。未来基于监狱的干预措施应利用社会支持、增强压力应对技能、促进药物治疗的可及性，并与惩教服务机构合作。
