Secondhand smoke in French prisons: to set evidence-based health policy
The prison population and the prison workers are massively exposed to secondhand smoke. Eight out of ten prisoners smoke in the indoor spaces. This is a major issue. The aim of this thesis is to set evidence-based health policy in prisons such as for the rest of public health. The method includes an analysis of the (grey and academic) literature and the referral letters of one of the two principal Ombudsmen for prisoners in France. The literature shows that tobacco smoking is rooted in prison since the 18th century. In France, its use was forbidden for the convicted inmates in 1839. It was authorized for women in 1968, and reauthorized for all prisonners in 1983. For the prison administration, tobacco can be used as a tool to influence prisonners behaviour, it serves to cope with the boredom and as transaction. Passive smoking generates discomfort is beyond the short and mid-term somatic symptoms. As a result the referral letters of prisoners indicate suicidal attempts, suicidal ideas and other severe psychiatric disorders. The dilemma of prison health good versus other considerations poses systematic administrative deadlock. This led to a first court case against the French state for the violation of the European Convention for Human Rights in October 2015. While an enhancement of the current smoking policy in French prisons is to provide smoke-free cells or wards, the WHO directives and the opinions of the French Parliament are to ring-fence tobacco use in outdoor spaces or smoking corners. Among those scenarios, it is key to enhance the consideration of the electronic cigarettes.