title: Implementation and impact of anti-smoking interventions in three prisons in the absence of appropriate legislation.
abstract: OBJECTIVE
  To assess the acceptability and impact of anti-smoking policies in three prisons in Switzerland.
  
  
  METHODS
  A before-after intervention study in A) an open prison for sentenced prisoners, B) a closed prison for sentenced prisoners, and C) a prison for pretrial detainees. Prisoners and staff were surveyed before (2009, n=417) and after (2010-2011, n=228) the interventions. Medical staff were trained to address tobacco dependence systematically in prisoners. In prison A, a partial smoking ban was extended. No additional protection against second-hand smoke was feasible in prisons B and C.
  
  
  RESULTS
  In prison A, more prisoners reported receiving medical help to quit smoking in 2011 (20%) than in 2009 (4%, p=0.012). In prison A, prisoners and staff reported less exposure to second-hand smoke in 2011 than in 2009: 31% of prisoners were exposed to smoke at workplaces in 2009 vs 8% in 2011 (p=0.001); in common rooms: 43% vs 8%, (p<0.001). No changes were observed in prisons B and C.
  
  
  CONCLUSIONS
  Reinforcement of non-smoking rules was possible in only one of the three prisons but had an impact on exposure to tobacco smoke and medical help to quit. Implementing anti-smoking policies in prisons is difficult in the absence of appropriate legislation.
authors.affiliation: Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva, Switzerland. Jean-Francois.Etter@unige.ch
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Etter
authors.forename: Catherine
authors.initials: C
authors.lastname: Ritter
authors.forename: Derek H
authors.initials: DH
authors.lastname: Christie
authors.forename: Martina
authors.initials: M
authors.lastname: Kunz
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Rieder
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Humair
authors.forename: Hans
authors.initials: H
authors.lastname: Wolff
authors.forename: Ariel
authors.initials: A
authors.lastname: Eytan
authors.forename: Corinne
authors.initials: C
authors.lastname: Wahl
authors.forename: Bernice
authors.initials: B
authors.lastname: Elger
mesh_terms: D000328:Adult; D001294:Attitude to Health; D005240:Feasibility Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016134:Organizational Policy; D011329:Prisoners; D011330:Prisons; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013557:Switzerland / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution