Summary of evaluation methods
| Type of economic evaluation | Costs/outcomes | Justification for inclusion | Sources | Cost-effectiveness measure |
| Cost-consequence analysis comparing three phases (preannouncement vs preparatory vs post implementation) | Costs (healthcare and personal spend on nicotine products) | No cost-effectiveness measure presented—balance sheet format presenting disaggregated costs and outcomes | ||
| GP/nurse visits (PiC and staff) | Potential for change with reduced exposure to tobacco/SHS (eg, for coughs and colds) | TIPs surveys of PiC and staff (all three phases) | ||
| Outpatient visits (PiC only) | Potential for change with reduced exposure to tobacco/SHS for smoking-related diseases | NHS NSS (ISD SMR00) (June 2016 to November 2019) | ||
| Inpatient stays (PiC only) | Potential for change with reduced exposure to tobacco/SHS for smoking-related diseases (eg, stays for cardiovascular events and respiratory disease) | NHS NSS (ISD SMR01) (June 2016 to November 2019) | ||
| Mental health stays (PiC only) | Potential for change with no licit access to tobacco, which could impact levels of distress | NHS NSS (ISD SMR04) (June 2016 to November 2019) | ||
| Accident and emergency (PiC only) | Potential for change with reduced exposure to tobacco/SHS for smoking-related diseases (eg, acute health events) and with no licit access to tobacco (eg, violence, including self-harm) | NHS NSS (ISD Unscheduled Care A&E2) (June 2016 to November 2019) | ||
| Ambulance (PiC only) | Potential for change with reduced exposure to tobacco/SHS for smoking-related diseases (eg, acute health events) and with no licit access to tobacco (eg, violence, including self-harm) | Scottish Prison Service (June 2016 to November 2019) | ||
| Medication—nicotine dependence and smoking-related illness (PiC only) | Potential for change with reduced exposure to tobacco/SHS (need for medication for smoking-related diseases), and with no licit access to tobacco (need for nicotine dependence products) | National Procurement, NHS NSS (June 2016 to November 2019) | ||
| Tobacco products (PiC and staff) | PiC—expected decrease when unavailable in canteen after implementation; staff—potential change in spend if influenced by policy | PiC—SPS canteen purchase data (3 months prior to implementation); staff—TIPs staff survey all three phases | ||
| E-cigarettes (PiC only) | Expected increased use with no licit access to tobacco in later phases | SPS canteen purchase data (3 months prior to implementation and 1 year after) | ||
| Outcomes (health and non-health related) | ||||
| Concentration of secondhand smoke (PM2.5) | Expected reduction due to policy implementation | TIPs study measurements (in all three phases) | ||
| Health-related quality of life—health utilities (PiC and staff) | Potential for change for PiC and staff due to reduced exposure to SHS and no licit access to tobacco | TIPs surveys for PiC and staff included a Euro-Qol-5D (EQ-5D) questionnaire (in all three phases) | ||
| Prisoner-on-staff assaults | Potential for change with no licit access to tobacco later in preparatory and post implementation phases | Scottish Prison Service (November 2017 to November 2019) | ||
| Prisoner-on-prisoner assaults | Potential for change with no licit access to tobacco later in preparatory and post implementation phases | Scottish Prison Service (November 2017 to November 2019) | ||
| All-cause mortality (deaths in custody—PiC) | Potential for change with reduced exposure to tobacco/SHS for smoking-related diseases | Scottish Prison Service (June 2016 to November 2019) | ||
| Fires | Potential for change due to no lighters permitted after implementation and frustration at no licit access to tobacco | Scottish Prison Service (June 2016 to November 2019) | ||
| Management of an Offender at Risk due to any Substance (MORS) policy | Potential for change with no licit access to tobacco and with the introduction of e-cigarettes in prisons | Scottish Prison Service (June 2016 to November 2019) | ||
| Cost-effectiveness analysis comparing absence and presence of smoke-free policy (preannouncement to post implementation phases) | Costs—total of all costs included in cost-consequence analysis | Potential for change due to absence of licit tobacco—details above | Various sources—details above | Incremental cost per 10 µg/m3 reduction in PM2.5 |
| Outcome—concentration of secondhand smoke (PM2.5) | Expected reduction due to policy implementation | TIPs study measurements (in all three phases) | ||
| Cost-utility analysis comparing absence and presence of smoke-free policy (preannouncement to post implementation phases) | Costs—total of all costs included in cost-consequence analysis | Potential for change due to absence of licit tobacco—details above | Incremental cost per quality-adjusted life-year | |
| Outcome—quality-adjusted life-years (PiC and staff) | Potential for change for PiC and staff due to reduced exposure to SHS and no licit access to tobacco | TIPs surveys for PiC and staff included an EQ-5D questionnaire (in all three phases) combined with 12-month time period | ||
A&E, accident and emergency; GP, general practitioner; ISD SMR, Information Services Division Scottish Morbidity Records; NHS NSS, National Health Service National Services Scotland; PiC, people in custody; PM, particulate matter; SHS, secondhand smoke; SPS, Scottish Prison Service; TIPs, Tobacco in Prisons.