title: Successes and unintended consequences of the Northern Territory's smoke-free prisons policy: results from a process evaluation.
abstract: OBJECTIVE
  In 2013, the Northern Territory was the first Australian jurisdiction to introduce a smoke-free policy for all correctional facilities. We report on a process evaluation to identify what worked well, key challenges and unintended consequences.
  
  
  METHODS
  We interviewed 87 people, comprising remand, medium-security and low-security prisoners; visiting family members; and prison staff (including prison management and health workers). A realist evaluation approach was used.
  
  
  RESULTS
  A long lead-in time, collaborative planning and a comprehensive communication strategy were vital for generating support for the policy and ensuring a smooth transition, with no riots or major incidents. Many prisoners expressed a preference for cessation support options other than nicotine replacement therapy (NRT). An unintended consequence was misuse of NRT patches.
  
  
  CONCLUSIONS
  A comprehensive approach to creating support among staff and prisoners is important for smooth implementation of policies for smoke-free prisons. Planning should include assessment of prisoners' preferred form of cessation support and strategies to minimise NRT diversion.
authors.affiliation: Menzies School of Health Research, Darwin, Northern Territory, Australia, marita.hefler@menzies.edu.au.
authors.forename: Marita
authors.initials: M
authors.lastname: Hefler
authors.affiliation: Northern Territory Department of Correctional Services, Darwin, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Hopkins
authors.affiliation: Menzies School of Health Research, Darwin, Northern Territory, Australia.
authors.forename: David P
authors.initials: DP
authors.lastname: Thomas
mesh_terms: D003142:Communication; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D015876:Northern Territory; D011329:Prisoners / Q000523:psychology*; D011330:Prisons; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D061845:Smoke-Free Policy