16. Tobacco use in prison settings: a need for policy implementation

Key points • Tobacco is the psychoactive substance most widely used by prisoners, with prevalence rates ranging from 64% to more than 90%, depending on the country and the setting. • Tobacco use is completely entangled in prison life where it helps to cope with boredom, deprivation or stress, relieve anxiety and tension and function as a source of pleasure or monetary value in an environment without currency. • Few measures other than the implementation of bans have been taken so far to reduce exposure to secondhand smoke (SHS), indicating the low priority attached to this factor in health promotion in prisons. • There is limited available evidence for best practice regarding smoking cessation in prison populations. More cessation programmes need to be implemented. Smoking by staff should be addressed systematically in tobacco control policies in prisons. Since the broader public health system should systematically include incarcerated people, national and local tobacco strategies and plans should include prisons.