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Smoking ban in prisons would lead to more assaults on staff

BMJ 2005; 331 doi: (Published 24 November 2005) Cite this as: BMJ 2005;331:1228
  1. Adrian O'Dowd
  1. London

    Doctors and other staff working in prisons would face a greater risk of assault if smoking were to be banned in that environment, the head of the prison service has told MPs.

    Phil Wheatley, director general of the Prison Service told the health select committee inquiry into smoking in public places last week that a complete ban would have serious repercussions and create control problems for staff.

    The government's current proposals to introduce a partial smoking ban in enclosed public places by 2007 under its Health Bill introduced to parliament last month, could cause problems, he believed.

    “I think prisons are special and the circumstances are special,” said Mr Wheatley. “It's important we take account of the fact that they are places in which people not only work but live, in many cases for years at a time.

    “I would expect to find there was an increase in incidents of assaults on staff, that we ended up with prisoners who were more likely to be troublesome and an increased risk of disorder.”

    Prisoners' welfare was also a consideration as he added, “We do need to make sure we do not cause significant problems for disturbed people arriving with us with already a multitude of problems, many of them coming off drugs, many of them with serious alcohol problems and many of them potentially suicidal.”

    Various options were being considered but he expected to have a situation in the future where prisoners could smoke in their own cells, in the open air and they would be segregated into groups of smokers and non-smokers to share cells, even though this could cause some accommodation problems.

    If a complete smoking ban was to be introduced for prisoners, among whom 80% were usually smokers, it would simply drive tobacco underground, he added, and make it more of an illicit currency than it already was.

    The issue of mental health premises being exempt from the government's plans was not straightforward, according to Paul Corry, director of campaigns and communications for charity Rethink Severe Mental Illness, who also gave evidence.

    Special considerations had to be made in this area as the antipsychotic drugs people might be on could be affected by giving up smoking.

    “Up to 70% of people with severe mental illness who are in institutional care of one kind or another will smoke,” he said.

    “I think it's difficult to imagine a situation at the moment where you could introduce a complete smoking ban in all psychiatric units given that a significant proportion of the people using them will be there under compulsion.”

    Drinks and hospitality representatives said they had been concerned at the less than complete ban on smoking proposed in England. Bob Cotton, chief executive of the British Hospitality Association, said of the 600 000 staff that his members employed, 90% said that they would rather have a comprehensive smoke free environment in which to work. “Quite clearly, a total ban is inevitable,” he said.

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