Implementation and impact of anti-smoking interventions in three prisons in the absence of appropriate legislation.

OBJECTIVE: To assess the acceptability and impact of anti-smoking policies in three prisons in Switzerland. METHODS: A before-after intervention study in A) an open prison for sentenced prisoners, B) a closed prison for sentenced prisoners, and C) a prison for pretrial detainees. Prisoners and staff were surveyed before (2009, n=417) and after (2010-2011, n=228) the interventions. Medical staff were trained to address tobacco dependence systematically in prisoners. In prison A, a partial smoking ban was extended. No additional protection against second-hand smoke was feasible in prisons B and C. RESULTS: In prison A, more prisoners reported receiving medical help to quit smoking in 2011 (20%) than in 2009 (4%, p=0.012). In prison A, prisoners and staff reported less exposure to second-hand smoke in 2011 than in 2009: 31% of prisoners were exposed to smoke at workplaces in 2009 vs 8% in 2011 (p=0.001); in common rooms: 43% vs 8%, (p<0.001). No changes were observed in prisons B and C. CONCLUSIONS: Reinforcement of non-smoking rules was possible in only one of the three prisons but had an impact on exposure to tobacco smoke and medical help to quit. Implementing anti-smoking policies in prisons is difficult in the absence of appropriate legislation.

Validation of English-language versions of three scales measuring attitudes towards smoking, smoking-related self-efficacy and the use of smoking cessation strategies.

AIMS: To assess the validity of English translations of three scales initially developed in French, measuring perception of the adverse effects of smoking, self-efficacy and the use of smoking cessation strategies. METHODS: Between 1999 and 2001, 5667 people from 97 countries (4724 smokers and 943 ex-smokers) answered the scales on the internet, of which 997 (18%) took part in a follow-up 86 days later. FINDINGS: The factor structures of the scales were generally maintained after translation. Internal consistency coefficients were 0.5-0.9. Test-retest reliability was >0.7 for the "Adverse effects" and self-efficacy scales, but was low (0.2-0.4) for self-change strategies, which probably reflects active use of these strategies in this sample. The translated scales performed adequately in most tests of construct validity. In particular, higher self-efficacy ratings predicted smoking cessation at follow-up, and a lower self-efficacy predicted relapse in baseline ex-smokers. CONCLUSION: The validity of the scales was maintained after translation in English.

Global networking for biodosimetry laboratory capacity surge in radiation emergencies.

For the public health management of radiation emergencies, one of the essential components of integrated risk assessment is to quickly and accurately assess and categorize the exposure. In addition to other methods, biodosimetry is instrumental to support decision-making for: 1) efficient secondary triage in a hospital response phase; 2) multi-parameter approach for defining best-treatment strategies for those severely exposed; 3) clinical prognosis and assessment of risk; and 4) reassurance and psychological support for those potentially exposed, or "worried-well." In large-scale events, the number of victims, and especially those worried-well, is likely to overwhelm hospital and laboratory capacities in the accident area. This is already being addressed through the networking approach within several countries and/or regions of the world. The paper reports about WHO's activity toward coordination of these regional efforts and the international collaborative network of biodosimetry laboratory services, WHO BioDoseNet. The network includes more than 30 laboratories around the world and supports the implementation of the revised International Health Regulations, the scope of which since 2007 also covers the field of radionuclear incidents.