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Brief intervention on Smoking, Nutrition, Alcohol and Physical (SNAP) inactivity for smoking relapse prevention after release from smoke-free prisons: a study protocol for a multicentre, investigator-blinded, randomised controlled trial
  1. Xingzhong Jin1,2,
  2. Stuart A Kinner3,4,5,6,7,
  3. Robyn Hopkins8,
  4. Emily Stockings1,
  5. Ryan J Courtney1,
  6. Anthony Shakeshaft1,
  7. Dennis Petrie4,9,
  8. Timothy Dobbins1,
  9. Kate Dolan1
  1. 1 National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
  2. 2 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
  3. 3 Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
  4. 4 Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  5. 5 Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
  6. 6 Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
  7. 7 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  8. 8 Northern Territory Correctional Services, Darwin, Northern Territory, Australia
  9. 9 Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Xingzhong Jin; xingzhong.jin{at}sydney.edu.au

Abstract

Introduction Smoking remains the leading risk factor for disease burden and mortality worldwide. Heavy Smoking is often associated with poor Nutrition, Alcohol abuse and Physical inactivity (known as ‘SNAP’). Australia’s first prison smoking ban was introduced in the Northern Territory in July 2013. However, relapse to smoking after release from prison is normative. Holistic and cost-effective interventions are needed to maintain post-release abstinence to realise the potential public health impact of smoke-free prison policies. Rigorous, large-scale trials of innovative and scalable interventions are crucial to inform tobacco control policies in correctional settings.

Methods and analysis This multicentre, investigator-blinded, randomised parallel superiority trial will evaluate the effectiveness of a brief intervention on SNAP versus usual care in preventing smoking relapse among people released from smoke-free prisons in the Northern Territory, Australia. A maximum of 824 participants will be enrolled and randomly assigned to either SNAP intervention or usual care at a 1:1 ratio at baseline. The primary endpoint is self-reported continuous smoking abstinence three months after release from prison, verified by breath carbon monoxide test. Secondary endpoints include seven-day point prevalence abstinence, time to first cigarette, number of cigarettes smoked post release, Health Eating Index for Australian Adults, Alcohol Use Disorder Identification Test-Consumption and International Physical Activity Questionnaire scores. The primary endpoint will be analysed on an intention-to-treat basis using a simple log binomial regression model with multiple imputation for missing outcome data. A cost-effectiveness analysis of the brief intervention will be conducted subsequently.

Ethics and dissemination This study was approved by the University of New South Wales Human Research Ethics Committee (HREC), Menzies HREC and Central Australia HREC. Primary results of the trial and each of the secondary endpoints will be submitted for publication in a peer-review journal.

Trial registration number ACTRN12617000217303; Pre-results.

  • clinical trials
  • public health
  • health policy

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors KD, SAK and RH conceived the study; KD, SAK, RH, ES, RJC, AS, DP, TD and XJ participated in study design; KD and XJ conducted the sample size calculation; TD provided statistical expertise; preparing study design, data collection and management is the responsibility of XJ, the study coordinator. XJ drafted the manuscript; all authors revised the manuscript and gave the final approval of the version to be submitted.

  • Funding The SNAP study is supported by the Australian Commonwealth Government Department of Health Tackling Indigenous Smoking Grant (TIS H151G6012). The design, management, analysis and reporting of the study are entirely independent of the funding body. The National Drug and Alcohol Research Centre at the University of New South Wales (UNSW), Australia, is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund and by infrastructure support from the UNSW, Australia.

  • Competing interests XJ is supported by an Australian National Health and Medical Research Centre (NHMRC) Early Career Fellowship (APP1143022). SAK is supported by an NHMRC Senior Research Fellowship (APP1078168). ES is supported by an Australian National Health and Medical Research Centre (NHMRC) Early Career Fellowship (APP1104600). RJC is supported by a Cancer Institute New South Wales Early Career Research Fellowship (GNT14/ECF/1-46). DP is supported by an Australian Research Council’s Discovery Early Career Award (Project DE150100309).

  • Patient consent Obtained.

  • Ethics approval This study was approved by the University of New South Wales Human Research Ethics Committee (HREC), the Menzies HREC and Central Australian HREC. The SNAP study is registered with the Australian New Zealand Clinical Trials Registry(ACTRN12617000217303).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Extra data are available by emailing Prof Kate Dolan (k.dolan@unsw.edu.au)