A randomised controlled study of the Health Intervention “SNAP” in Northern Territory prisons- where smoking is banned- to prevent relapse to smoking

Participants who are randomly allocated to the intervention group will receive one session of 30 to 60 minutes of SNAP brief intervention, which aims to improve participants’ health, specifically through preventing them from returning to Smoking, improving their Nutrition through healthier eating, reducing or ceasing Alcohol consumption and increasing Physical activity. A Clinical Psychologist Consultant with 25 years' experience designed the SNAP intervention for this trial based on the theoretical model of Motivational Interviewing. Four research assistants who are trained by the Clinical Psychologist Consultant and have passed the qualification assessment will deliver the intervention face-to-face in a prison interview room after the baseline interview, which is within two weeks before the participants' release date. An illustrative SNAP pamphlet will be given to the participants to facilitate the intervention. The SNAP intervention will focus on Smoking in an attempt to maintain abstinence after prison release. The delivery of the SNAP intervention relies on the 5A’s framework, which is adopted in the SNAP guide by the Royal Australian College of General Practitioners (RACGP): 1. Ask (identify risk factors for smoking and affirm choice not to smoke) 2. Assess (assess the level of motivation and their readiness to change) 3. Advise (provide feedback, advice and motivational interviewing based on readiness level), 4. Assist (develop a strategic and risk management plans and provide support for self-monitoring) 5. Arrange (refer to special services, offer Quitline phone counselling information, arrange follow-up with GP). Participants identified as having other risk factors will receive advice on how to modify their risk as per below: 1. Poor Nutrition: Give brief advice according to Australian Guide to Healthy Eating and refer to eatforhealth.gov.au website. 2. Hazardous drinking: Referral to drug and alcohol services. 3. Physical inactivity: Give brief advice based on Australian's Physical Activity and Sedentary Behaviour Guidelines. At the end of the intervention, participants will receive a pre-release bag which contains: - Australian Guide to Healthy Eating posters - Australian's Physical Activity and Sedentary Behaviour Guidelines for Adults (18-64 years) posters - Quitline posters and magnet - My Quitbuddy App Card - Follow-up card with 'My Health, My Family, My Pocket.' printed on the back. Participant engagement underlies the success of the SNAP intervention. Therefore the intervention is designed to be a client-centred conversation that will be tailored to individual participant's interest and motivation during the session. Intervention fidelity will be assessed in a two-weeks pilot where two intervention sessions for each research assistant will be audiotaped. The Clinical Psychologist Consultant will review the audio records and provide feedback. We will maintain intervention adherence by randomly select one session every month for each research assistant to be audio-recorded, and reviewed with feedback by the Consultant.