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No smoker left behind: it's time to tackle tobacco in Australian priority populations

To the Editor: 
 
We read with interest the recent article by Bonevski and colleagues1 calling for targeting of tobacco cessation interventions to high‐risk populations, including prisoners. People who cycle through prisons in Australia smoke tobacco at a rate five times that of the general population,2 and suffer disproportionately from smoking‐related morbidity and mortality.3 However, the suggestion by Bonevski and colleagues1 that smoke‐free policies in prisons “impact on reducing smoking” is unfortunately a case of misplaced optimism: although these policies reduce smoking in prisons, they have almost no effect on long term smoking behaviour in people who cycle through prisons. Research in the United States shows that about 60% of people released from smoke‐free prisons resume smoking on the day of release,4 and 97% relapse within 6 months of release.5 Preliminary findings from a cross‐sectional survey we have conducted with 114 ex‐smokers released from smoke‐free prisons in Queensland paint a similar picture, with 72% of participants reporting relapse on the day of release.