Measures to encourage smoking cessation in detention

Incarceration is sometimes the first contact between a prisoner and health services. Prison can be an opportunity to meet tobacco professionals and initiate a process of smoking cessation or at least risk reduction for an individual in detention.[1].

The law of 18 January 1994 on public health and social protection states that the quality of care in prison must be equivalent to that of the general population: this is the principle of equivalence. At the start of their incarceration, the prisoner is offered a health check-up related to their consumption of addictive products, including tobacco (law on the modernization of the health system of 26 January 2016, articles 41 and 44).

In the penitentiary environment, health promotion involves an approach focused on the determinants of the person's health and behavioral variables. These determinants cover the environment of the individual in detention (possibility of being assigned to a non-smoking cell), living conditions (promotion of sport and combating idleness), risk reduction (promotion of e-cigarettes)[2].

Public health promotion aims at risk reduction rather than withdrawal, which is not recommended in the immediate future, due to the strong psychological pressures experienced by prisoners. In this perspective, the electronic cigarette is a risk reduction tool. Since 2014, prisoners have had the right to access electronic cigarettes, which can be found in the canteen[3].

However, these public health measures are still insufficiently and unevenly developed. In 2016, 81% of the male prison population smoked (Read theThe contradictions of the fight against smoking in prisonsThe majority of prisoners come from disadvantaged social backgrounds and did not benefit from solid health care before their incarceration.