Attitudes of detainees and prison staff towards tobacco control policy in Switzerland: a qualitative interview study.
OBJECTIVE
To explore detainees and staff's attitudes towards tobacco use, in order to assist prison administrators to develop an ethically acceptable tobacco control policy based on stakeholders' opinion.


METHODS
Qualitative study based on in-depth semi-structured interviews with 31 prisoners and 27 staff prior (T1) and after the implementation (T2) of a new smoke-free regulation (2009) in a Swiss male post-trial prison consisting of 120 detainees and 120 employees.


RESULTS
At T1, smoking was allowed in common indoor rooms and most working places. Both groups of participants expressed the need for a more uniform and stricter regulation, with general opposition towards a total smoking ban. Expressed fears and difficulties regarding a stricter regulation were increased stress on detainees and strain on staff, violence, riots, loss of control on detainees, and changes in social life. At T2, participants expressed predominantly satisfaction. They reported reduction in their own tobacco use and a better protection against second-hand smoke. However, enforcement was incomplete. The debate was felt as being concentrated on regulation only, leaving aside the subject of tobacco reduction or cessation support.


CONCLUSIONS
Besides an appropriate smoke-free regulation, further developments are necessary in order to have a comprehensive tobacco control policy in prisons.
University Centre of Legal Medicine of Geneva and Lausanne, 9 av. de Champel, 1211 Geneva 4, Switzerland. Electronic address: Catherine.Ritter@unige.ch.
Catherine
C
Ritter
Institute of Biomedical Ethics of the University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland.
Bernice S
BS
Elger
D001294:Attitude to Health; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D016134:Organizational Policy; D011050:Policy Making; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D011330:Prisons / Q000458:organization & administration*; D036301:Qualitative Research; D061845:Smoke-Free Policy; D012907:Smoking / Q000523:psychology; D000074606:Smoking Prevention; D013557:Switzerland / Q000453:epidemiology; D000078329:Workforce
Prison; Second-hand smoke; Smoking regulation; Tobacco cessation support; Tobacco control policy