How Vaping Has Surged Among Prisoners in the UK

Oct 27, 2023

Prisoners in the United Kingdom spent close to £8 million on nicotine vapes in the 2021-22 financial year, according to Ministry of Justice figures recently obtained by Metro. That's up from about £4.5 million a couple of years previously. Vapes have been available in prisons since 2015, and prisoners who smoke are also able to access nicotine replacement therapy (NRT).

The sharp rise in vaping has happened in the context of a total smoking ban in all UK prisons (since 2017, in England and Wales), which some question on ethical and practical grounds. The Ministry of Justice now portrays England as having the largest "smoke-free" prison system in Western Europe.

Vapes can be purchased in prison canteens, with prisoners using "their own money," and "which many use to help quit tobacco," a Ministry spokesperson emphasized to Metro.

A 2015 government paper stated that people in prison smoked at about four times the rate of the general population. When vaping is vastly less harmful than smoking, and also more effective for smoking cessation than NRT, the mass switch looks like a win in public health terms.

They frequently tell her their first experience of vaping was in prison, and "some have stayed smoke-free ever since."

"The fact that many people have access to vaping products is welcome news from a tobacco harm reduction perspective," Debbie Robson, senior lecturer in tobacco harm reduction at King's College London, told Filter. "Great progress has been made in creating a smoke-free prison estate, despite doubting it was achievable given the high smoking rates in prison settings."

Robson, who is also a mental health nurse, often speaks with formerly incarcerated people while conducting her research. She said they frequently tell her that their first experience of vaping was in prison, and "some have stayed smoke-free ever since."

"As a nurse, that makes me question why a prison setting may be the first time someone has the opportunity to use a vape," she added. Outside the prison system, she thinks that "health and social care practitioners can do more to raise awareness and reduce barriers to vaping in groups where smoking prevalence is high."

Smoking rates are high in the low-income communities whose members are disproportionately incarcerated. A 2018 report by the Office of National Statistics and Public Health England showed that the likelihood of someone smoking is "increased in line with the level of deprivation in their neighborhood."

But has prison vaping uptake come at a high cost? There are different views about the smoking ban, which could be seen as inflicting further punishment on people for whom cigarettes are a rare comfort in distressing conditions.

The Howard League for Penal Reform is a leading prisons charity in the UK. Its director of campaigns, Andrew Neilson, told Filter that his organization "has supported making prisons smoke-free in principle, given the health risks to both prisoners and staff."

"But we’ve always been concerned that the ban was implemented responsibly and that prisoners were given the proper support and resources to move away from smoking," he continued. He cited a general lack of provisions to support mental and physical health, including a lack of access to fresh air. "Prisons are still struggling to deliver these kind of open regimes after the pandemic effectively locked prisons down and saw people kept in their cells 23 hours a day."

It raises a lot of questions, he said, when a prison cell is a person's residence, and when "people still want to smoke."

Ethical questions about the ban hinge on the multiple roles of prisons—as public spaces, workplaces, and also effectively the homes of people who are held there.

Andy West teaches philosophy in prisons, and authored a memoir about his experiences. The justification for the ban, he told Filter, is that it's in line with equivalent bans in other public spaces, and "it's nicer to not have to inhale smoke at work now."

But it raises a lot of questions, he said, when a prison cell is a person's residence, and when "people still want to smoke" and "prisons seem to stoke addictions."

In any case, tobacco is still available illicitly in prisons, which is "more dangerous," he said. "Prohibition always creates a bigger monster than the one it kills."

Omar Mentesh was released from prison in 2017, the year the smoking ban was implemented. He now mentors other formerly incarcerated people as they return to society.

He told Filter that he has witnessed the "absolute horror" associated with prison tobacco markets. "I was around heavy smokers, where they would do anything for one burn. Literally sell their food for the day for a couple of roll-ups."

Could a different policy have successfully promoted safer alternatives to smoking while avoiding these harms?

Mentesh said that tobacco inside can now reach costs of up to £500 an ounce, enabling some prisoners and corrupt staff to enrich themselves. Consequences, he continued, include "people being in debt due to ‘double-double’ borrowing, resulting in violence, self-harm and people locking themselves in their cells due to being unable to pay."

Could a different policy have successfully promoted safer alternatives to smoking while avoiding these harms?

Perhaps this might have looked like allowing people to smoke outdoors or in their own cells, combined with continuing to allow canteen purchases of tobacco—but offering free vapes as a heavily incentivized alternative.

The idea isn't as outlandish as it might sound, when the UK government recently announced it would provide free vape starter kits to one million people who smoke in England. And in Scotland, where the prisons smoking ban wasn't implemented until 2018, prisoners were temporarily provided free and then discounted vapes in advance of the ban taking effect.

Still, the health impacts of smoking, including on incarcerated people and staff who don't smoke, make Mentesh describe the ban as "a good thing" overall.

Robson, who has seen people continue vaping instead of smoking after leaving prison, also supports the ban, while believing conditions and options must be improved.

Nicotine plays an important role for many people with mental health conditions, who have extremely high smoking rates worldwide. An estimated 48 percent of men and 70 percent of women in prison in England and Wales have mental health conditions. And some studies have suggested that nicotine can improve cognitive performance and enhance mood.

But when it comes to smoking specifically, Robson cited research finding "evidence that mental health does not worsen as a result of quitting smoking, and very low‐ to moderate‐certainty evidence that smoking cessation is associated with small to moderate improvements in mental health."

"Facilitating killing time by smoking isn't something we should strive for," she said.

The UK's prison population was just under 82,000 at the end of 2022. Its incarceration rate, at 129 people per 100,000 population, is far lower than that in the United States (664 per 100,000), but still the highest in Western Europe.

Photograph of Wormwood Scrubs prison in London by Chmee2 via Wikimedia Commons/Creative Commons 3.0