Smoking in French prisons: Factors associated with consumption and cessation

For the past twenty years, researchers have emphasized the importance of producing data on tobacco use among incarcerated people. With a prevalence rate that can reach 97% in some countries, smoking is much more frequent in that population compared to the general population and this constitutes one of the main causes of chronic pathologies and mortality in prisons. In France, more than 80% of inmates use tobacco while the prevalence of smoking is 31.9% in the general population in 2021. In a global context of decreasing smoking rates, tobacco use in prison contributes to the persistence of social inequalities in health. This article presents the results of a sociological study which was part of the diagnostic phase of an interventional study whose overreaching goal was to construct, implement and evaluate an intervention aiming to reduce tobacco use in prisons. The objective of this paper is to identify the factors associated with tobacco use among inmates as well as the factors that hinder or facilitate the cessation process. Qualitative interviews with 21 inmates and 30 professionals were conducted and analysed thematically, using an inductive approach and Nvivo software. In light of our findings, we discuss the importance of behavioral awareness and the community-based approach that are essential to the construction and implementation of a relevant and acceptable public health program.