The aim of this brief is to shed light on the scale of the noncommunicable disease (‎NCD)‎ burden in prisons and the unique challenges they present for individuals and society both during and following incarceration. The brief also highlights best practices, interventions and policies to address NCDs and their risk factors in the prison context, while also noting special considerations for their implementation in specific contexts and settings.

P.29 4.3 Reducing alcohol use
P.31 4.4 Reducing tobacco use

For several decades WHO has focused its attention on four major risk factors that are shared by most NCDs, including tobacco and alcohol use, low levels of physical activity and unbalanced diet. More recently, environmental pollution and other environmental risks have been highlighted as a cause of concern, as they are estimated to be currently responsible for nearly a quarter of deaths. In addition, there are other risk factors that are typically applicable to certain NCDs, as is the case with drug use, which has a particular impact on mental health and behaviour. The overlap and interplay between multiple risk factors are common, suggesting that interventions should target multiple risk factors in order to affect multiple NCDs simultaneously.

P.55 Box 7. Peer-to-peer health and first aid programme in Ireland
In 2009 Ireland became the first country in the world to introduce a community-based health and first aid programme in prisons, in which detainees themselves became volunteer and health peer mentors. Established as an interdisciplinary partnership between the Irish Red Cross and education and justice authorities, by 2014 the programme had expanded to 14 prisons in the country and led to the implementation of 200 peer-based health promotion projects in areas covering HIV and hepatitis C screening, overdose prevention, and education on communicable and noncommunicable diseases. Evaluations of the programme demonstrated positive individual outcomes, including greater health awareness and empowerment, and community-wide improvements, such as greater bonds, higher testing rates and positive developments in the prison environment. The programme was awarded the WHO Best Practice in Prison Health Award in 2011.