Successes and unintended consequences of the Northern Territory’s smoke-free prisons policy: results from a process evaluation

Abstract

Objectives: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.