Implementation, delivery and perceived effectiveness of a peer intervention for smoke-free living and health improvement for people in custody

Background: Smokefree legislation was introduced in all Scottish prisons from 30th November 2018.

Although initial implementation appears successful, building on the new legislation to help people in custody (prisoners) remain abstinent from smoking in the longer term presents new challenges and opportunities.

Following the smoking ban, NHS Greater Glasgow and Clyde (GGC) are piloting a novel peer intervention for smokefree living and health improvement for people in custody.

The intervention seeks to support both peer mentors and recipients of health-related activities to manage and decrease nicotine dependence in prison and make sustainable improvements to overall health and wellbeing, including long-term smoking abstinence.

Peer mentors will have opportunities to develop life skills and qualifications which can strengthen individual and social capital in disadvantaged communities.

The proposed study of this peer intervention will address gaps in evidence on integrated health promotion activities in institutions that have removed tobacco.

The study builds on complementary studies on prison tobacco bans (NIHR funded) and e-cigarettes (CRUK TAG funded) in Scottish prisons, being conducted by joint lead applicants Ashley Brown and Kate Hunt, and co-applicant Linda Bauld, and existing close partnerships with GGC, and the Scottish Prison Service (SPS).

Aims: The overall aim is to qualitatively explore the design, implementation, delivery and perceived effectiveness of the peer intervention, from the perspectives of people in custody and staff.

Objectives are to: 1. investigate the design, implementation, delivery and perceived effectiveness of the peer intervention from the perspectives of people in custody and staff. 2. gather evidence to optimise ongoing delivery of the intervention in three prisons in GGC, and to support similar delivery in jurisdictions, in Scotland and elsewhere, seeking to implement peer-delivered health promotion initiatives in smokefree prisons.

Methodology: One-to-one in-depth qualitative interviews with a purposely selected sample of people in custody and staff (N=27), and observations (N=9) of training of peer mentors and delivery of health-related activities as appropriate.

The research team will explore the feasibility of conducting an analysis of routinely collected data to strengthen understanding of the intervention.

Results: Emergent findings will be fed back to stakeholders on an ongoing basis to inform intervention delivery, and support early identification and rectification of problems.

Evaluation of the intervention will inform the evidence base in the UK and internationally in respect of what can be done to fully capitalise on the potential of institutional smoking bans to support long-term health improvement and abstinence post-release.