Criminal Justice & Prisons

Prisons and Tobacco Control (inc Smoking Cessation)
Part of DH Tobacco Control Health Inequalities Pilot Projects Programme
(Commissioned by the Department of Health) 

This project aimed to develop and share knowledge and learning in relation to smoking cessation in prisons and broadening out to other organisations across the criminal justice system that also had the potential to contribute to quitting and to generic services. It encompassed broad target groups such as offenders, families and staff within the criminal justice system. It aimed to develop functioning systems for provision of support and care pathways, in prisons, on release, across the CJS, and into the community, which would result in enhanced engagement and quit rates. A Regional Criminal Justice System (CJS) Tobacco Control Coordinator was appointed to look toward the organisational/systems perspectives across prisons, probation services, police and courts in relation to tobacco control and stop smoking support and treatment, and full process and outcomes evaluation were conducted. This was part of an overall bid coordinated by UKCTCS covering six settings in all.

CTCR Staff: Susan MacAskill, Douglas Eadie and Jennifer McKell

Eadie D, MacAskill S, McKell J and Baybutt M (2012). Barriers and facilitators to a criminal justice tobacco control coordinator: An innovative approach to supporting smoking cessation among offenders. Addiction, 107(Suppl2): 26-38.

Prison Health Needs Assessment for Alcohol Problems
(Commissioned by NHS Health Scotland) 

Alcohol problems are a major and growing public health problem in Scotland with the relationship between alcohol and crime, in particular violent crime, increasingly being recognised. This study was part of a wider Scottish Government funded alcohol research programme in criminal justice settings which also included a pilot of the delivery of alcohol brief interventions and a scoping study of alcohol interventions in community justice settings. It was anticipated that the study findings would inform broader health service development such as the integration of prison health care into the NHS and the update of core alcohol treatment and support services. These developments were set within a policy and practice context which acknowledged alcohol problems in the population and increasingly so the alcohol problem in offenders, along with the importance of applying a person-centred, recovery orientated approach underpinned by the NHS commitment to quality of services.

The aim of this study was to undertake a needs assessment of alcohol problems experienced by prisoners and provide recommendations for service improvement including a model of care. Key elements included:

  • a rapid review of the relevant literature on effective interventions
  • a report on the epidemiology of alcohol problems experienced by prisoners in Scotland
  • an assessment of alcohol problems among offenders within an individual prison using the AUDIT screening tool
  • mapping current models of care in the Scottish Prison Service and the interface with community care models
  • exploration of attitudes towards the delivery and effectiveness of current alcohol interventions through qualitative interviews in a prison case study
  • a gap analysis between current service provision, best practice, effective interventions and national care standards for substance misuse.

The study involved both quantitative and qualitative information being gathered through primary data collection and document retrieval and analysis.

The final report was launched at the Alcohol & Offenders Event, Edinburgh, 8th February 2011. Tessa Parkes presentation from this event can be found here. Conference presentations and paper submissions are ongoing.

ISM Staff: Susan MacAskill, Douglas Eadie and Oona Brooks (left 2010)

Collaborators: Tessa Parkes (lead), Ruth Jepson, Iain Atherton, Lawrence Doi and Stephen McGhee, School of Nursing, Midwifery and Health, University of Stirling

Tackling Blood-borne Viruses in Prisons in England & Wales: An Evaluation of the Department of Health's Disease Prevention and Health Promotion Policies and Programme Initiatives
(Commissioned by Offender Health at the Department of Health)

The study evaluated the Department of Health's disease prevention and health promotion policies and programme initiatives for tackling blood-borne viruses in prisons in England & Wales. Blood-borne viruses (BBVs) can cause serious illness and death. In 2007/2008, a series of policy and programme initiatives were instigated in prisons in England & Wales to prevent and control BBVs.

The study was designed to assess: the impact of the disinfectant tablets programme; the impact of the Hepatitis B Key Performance Indicators (KPIs); the impact of BBV programme elements on voluntary uptake of tests among prisoners; and, the response to and impact of exposure to disease prevention and health promotion materials. In addition, the study aimed to: identify enabling factors and barriers which have an effect on implementation of the relevant policies and programme initiatives; examine interactive effects between varying prevention and screening interventions and health promotion initiatives; and identify best practice and provide practical recommendations for future service and policy development, as well as identification of further research needs.

A combination of qualitative and qualitative data collection was used as the research aimed both to gain top level information across all prisons, and to explore in-depth implementation and impact in a select number of case study prisons. Process evaluation was a key element, as well as identifying and quantifying outcomes where possible. This gave important insights into ‘why' and ‘how' the impacts occurred and helped develop key learning for best practice in BBV prevention and health promotion.

Main data collection stages were:

  • Mapping - Mapping BBV related activity across all relevant prisons across the key areas of enquiry.
  • Prison Case Studies - In-depth examination of key implementation activities and impact issues in eight selected prisons, including interviews with staff and prisoners.

ISM Staff: Susan MacAskill, Oona Brooks (left 2010), Douglas Eadie and Martine Stead

Collaborator: Michelle Baybutt from the Healthy Settings Development Unit, School of Public Health and Clinical Sciences, University of Central Lancashire

Follow-Up Study Of DH Funded Provision of NRT in HM Prisons
(Commissioned by Prison Health and the Tobacco Policy Team at the Department of Health)

This study evaluated the impact of Department of Health-funded NRT in prisons from 2003-2005. The research adopted a case study approach, using a mix of quantitative and qualitative methods to explore processes relating to the administration of NRT in the prison context, and to measure smoking cessation outcomes over one year. Projects in a number of prisons in the North West Region in England were evaluated.

CTCR Staff: Susan MacAskill and Douglas Eadie

MacAskill S (2005). The Impact of DH Funded Provision of NRT in HM Prisons. Revised Findings. Stirling: Institute for Social Marketing, University of Stirling, November. Available here

MacAskill S and Hayton P (2007). Stop Smoking Support in HM Prisons: The Impact of Nicotine Replacement Therapy - Executive Summary and Best Practice Checklist. Stirling: Institute for Social Marketing, University of Stirling, March. Available here

Tobacco-Related Work in Prisons
(Commissioned by Prison Health and the Tobacco Policy Team at the Department of Health)

A mapping exercise was undertaken of current and planned smoking cessation work with prisoners and staff, and of wider prison tobacco-related activities, across NHS smoking cessation services and HM Prison Service. The information was disseminated in seminars held across England and Wales and will facilitate future developments in this key area.

CTCR Staff: Susan MacAskill and Susan Anderson (left 2005)

A Social Marketing Approach to Rethinking Crime and Punishment

(Commissioned by the Esmée Fairbairn Foundation)

Rethinking Crime and Punishment is a strategic initiative set up by the Esmée Fairbairn Foundation. It aims to raise the level of public debate about the use of prison and alternative forms of punishment in the UK. The first phase of this initiative was a £3 million directed grant making programme to fund a range of projects to increase public understanding and involvement in the criminal justice system. The grant making was been underpinned by research into the effectiveness of the current system and on public attitudes to criminal justice. More than 50 projects working to increase public understanding of, and involvement in criminal justice have been funded. The initiative has also set up a major independent Inquiry (the 'Coulsfield Inquiry') into Alternatives to Prison.

Our research for the initiative was, to our knowledge, the first application of social marketing in this area. Specifically it sought to test and demonstrate the value of social marketing as a tool for influencing public, organisational and governmental attitudes towards non-custodial sentencing options. The research included a stakeholder analysis of key interest and target groups; analysis of recent and current efforts by a range of different organisations to influence public, media and policy agendas about crime and punishment; and consumer research with members of the public exploring public perceptions of non-custodial sentences. These findings informed the development of a focused marketing strategy for the initiative and a detailed marketing plan.

ISM Staff: Martine Stead, Lynn MacFadyen and Gerard Hastings

Stead M, MacFadyen L and Hastings GB (2002). What do the public really feel about non-custodial penalties? Rethinking Crime and Punishment. Esmée Fairbairn Foundation. Online

Hastings GB, Stead M and MacFadyen L (2002). Reducing prison numbers: Does marketing hold the key? Criminal Justice Matters (CJM), 49: 20-21, 43.

Smoking Cessation in Prisons

(Commissioned by the Department of Health and Prison Health)

Around 80% of the UK 's prison population smoke and the prison setting represents an opportunity to access key smoking cessation target groups that are normally hard to reach, for example disadvantaged populations and younger men. The Department of Health and the Prison Service commissioned an evaluation of pilot interventions in four prisons in conjunction with local smoking cessation services (MacAskill & Eadie 2002). This showed substantial quit rates could be achieved, as well as providing insights into barriers and facilitating factors in service delivery. The results informed the content of the toolkit document 'Acquitted', published by the Department of Health in March 2003 (Braham 2003).

A second questionnaire based study mapped tobacco related activity across HM Prison Service and NHS smoking cessation services (MacAskill & Eadie 2003). Results were actively disseminated, including regional road shows aimed to promote 'Acquitted' and to encourage focus on the issue across the PCT and prison service interface at a local level.

The earlier findings contributed to the Department of Health decision to provide £500,000 of ring-fenced funding for provision of Nicotine Replacement Therapy (2003-2006). Our third study gathered insights into the impact of this funding, as well as service models and approaches, and informed policy and practice across the prison estate and PCTs hosting prisons (MacAskill 2006). Findings have been presented at various seminars, including an invited workshop and poster at the UK National Smoking Cessation Conference. Key findings and a 'best practice checklist' have been published and were 'launched' at a national conference in March 2007 which also addressed Smokefree issues in this setting. All reports are available here.

CTCR Staff: Susan MacAskill, Douglas Eadie and Martine Stead

Eadie D, MacAskill S, McKell J and Baybutt M (2012). Barriers and facilitators to a criminal justice tobacco control coordinator: An innovative approach to supporting smoking cessation among offenders. Addiction, 107(Suppl2): 26-38.

MacAskill S, Lindridge A, Stead M, Eadie D, Hayton P and Braham M (2008). Social marketing with challenging target groups: Smoking cessation in prisons in England and Wales. International Journal of Nonprofit and Voluntary Sector Marketing, 13(3): 251-261.

MacAskill S and Eadie DR (2002). Evaluation of a Pilot Project on Smoking Cessation in Prisons - Final Report. Glasgow: University of Strathclyde, Centre for Tobacco Control Research.

Braham MW (ed) (2003). Acquitted: best practice guidance for developing smoking cessation services in prisons. London: Department of Health / HM Prison Service.

Report available in PDF format

Evaluation of Jurors' Information Needs

(Commissioned by the Scottish Office, now Scottish Executive)

This qualitative study, initiated by the Scottish Courts Service, explored jurors' perceptions and understanding of jury service and assessed the extent to which the booklet 'Information for Jurors' met the information needs of members of the public called for jury service in Scotland (Stead et al 1997). The Scottish Courts Service used the research to provide guidance on both the development of the booklet and on other aspects of information provision for jurors.

ISM Staff: Martine Stead and Lynn MacFadyen

Stead M, MacFadyen L, Hastings GB and Eadie DR (1997). Information needs of Scottish jurors: Evaluation of the Scottish Courts Service booklet. Crime and Criminal Justice Research Findings No 18. Edinburgh: The Scottish Office Central Research Unit: HMSO. ISBN 0-748-66114-X.


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