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Lupez EL, Woolhandler S, Himmelstein DU, Hawks L, Dickman S, Gaffney A, Bor D, Schrier E, Cai C, Azaroff LS, McCormick D. Health, Access to Care, and Financial Barriers to Care Among People Incarcerated in US Prisons. JAMA Intern Med 2024:2821730. [PMID: 39102251 DOI: 10.1001/jamainternmed.2024.3567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Importance Decades-old data indicate that people imprisoned in the US have poor access to health care despite their constitutional right to care. Most prisons impose co-payments for at least some medical visits. No recent national studies have assessed access to care or whether co-pays are associated with worse access. Objective To determine the proportion of people who are incarcerated with health problems or pregnancy who used health services, changes in the prevalence of those conditions since 2004, and the association between their state's standard prison co-payment and care receipt in 2016. Design, Setting, and Participants This cross-sectional analysis was conducted in October 2023 and used data from the Bureau of Justice Statistics' 2016 Survey of Prison Inmates, a nationally representative sample of adults in state or federal prisons, with some comparisons to the 2004 version of that survey. Exposures The state's standard, per-visit co-payment amount in 2016 compared with weekly earnings at the prison's minimum wage. Main Outcomes and Measures Self-reported prevalence of 13 chronic physical conditions, 6 mental health conditions, and current severe psychological distress assessed using the Kessler Psychological Distress Scale; proportion of respondents with such problems who did not receive any clinician visit or treatment; and adjusted odds ratios (aORs) comparing the likelihood of no clinician visit according to co-payment level. Results Of 1 421 700 (unweighted: n = 24 848; mean [SD] age, 35.3 [0.3] years; 93.2% male individuals) prison residents in 2016, 61.7% (up from 55.9% in 2004) reported 1 or more chronic physical conditions; among them, 13.8% had received no medical visit since incarceration. A total of 40.1% of respondents reported ever having a mental health condition (up from 24.5% in 2004), of whom 33.0% had received no mental health treatment. A total of 13.3% of respondents met criteria for severe psychological distress, of whom 41.7% had not received mental health treatment in prison. Of state prison residents, 90.4% were in facilities requiring co-payments, including 63.3% in facilities with co-payments exceeding 1 week's prison wage. Co-payments, particularly when high, were associated with not receiving a needed health care visit (co-pay ≤1 week's wage: aOR, 1.43; 95% CI, 1.10-1.86; co-pay >1 week's wage: aOR, 2.17; 95% CI, 1.61-2.93). Conclusions and Relevance This cross-sectional study found that many people who are incarcerated with health problems received no care, particularly in facilities charging co-payments for medical visits.
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Affiliation(s)
- Emily Lupton Lupez
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Steffie Woolhandler
- Harvard Medical School, Boston, Massachusetts
- City University of New York at Hunter College, New York
| | - David U Himmelstein
- Harvard Medical School, Boston, Massachusetts
- City University of New York at Hunter College, New York
| | - Laura Hawks
- Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee
| | | | - Adam Gaffney
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - David Bor
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | | | - Chris Cai
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lenore S Azaroff
- Edward M. Kennedy Community Health Center, Worcester, Massachusetts
| | - Danny McCormick
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Garver-Apgar CE, Morris CM, Pavlik J, Lenartz T, Hamm M. Peer-Facilitated Tobacco Cessation in a Prison Setting: A Proof of Concept Study. Tob Use Insights 2023; 16:1179173X231168511. [PMID: 37051590 PMCID: PMC10084529 DOI: 10.1177/1179173x231168511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Background Despite the vast human and economic costs associated with tobacco use among U.S. inmates, smoking remains a largely ignored public health epidemic. Incarcerated individuals smoke at 3 to 4 times the rate of the general population and face tobacco-related health disparities. Purpose This paper reports results from a single arm, pre/post pilot study designed to test the feasibility and initial effectiveness of an inmate-administered group tobacco cessation intervention within a men’s pre-release program run by the Arizona Department of Corrections. Methods Corrections staff and inmate peer mentors were trained in the DIMENSIONS: Tobacco Free Program, a manualized 6-session tobacco cessation group curriculum. Group sessions used evidence-based interventions for assisting inmates develop skills to live tobacco and nicotine free. In 2019-2020, 39 men who reported tobacco use voluntarily participated in one of three cessation groups. Wilcoxen signed-rank tests evaluated changes across group sessions in frequency of tobacco use and attitudes about nicotine-free living post release. Results Most participants attended all six group sessions (79%) and made one or more quit attempts (78%). Overall, 24% of the sample reported quitting tobacco, and significant reductions in tobacco use were reported after only two sessions. Participants further reported significant positive changes in knowledge, plans, support, and confidence to live tobacco-free lives post-release. Conclusions To our knowledge, this is the first study to demonstrate that, with minimal investment, implementation of an evidence-based, peer-led tobacco free program is feasible and effective within an incarcerated population uniquely vulnerable to the burden of tobacco.
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Affiliation(s)
| | - Chad M. Morris
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jim Pavlik
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Sourry RJ, Hyslop F, Butler TG, Richmond RL. Impact of smoking bans and other smoking cessation interventions in prisons, mental health and substance use treatment settings: A systematic review of the evidence. Drug Alcohol Rev 2022; 41:1528-1542. [PMID: 36097413 DOI: 10.1111/dar.13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
ISSUES We conducted a systematic review to examine whether smoking bans alone are effective in achieving smoking cessation in people released from prison, and patients discharged from mental health or substance use settings. APPROACH We searched health, criminology and social science databases. Detailed search strings were used to combine terms related to smoking bans and cessation interventions in prison, mental health and substance use treatment settings. We used backward and forward snowballing and manual hand searching to find additional studies. Studies were included if they: were published between 1 January 2000 and 25 February 2022; included a complete smoking ban; measured people released from prison and/or mental health and/or substance use patients smoking post-release/discharge from a smoke-free facility; and reported smoking cessation intervention and/or smoking ban outcomes. Methodological quality was assessed using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies and reviewed by two authors. KEY FINDINGS People released from prison, mental health and substance use in-patients who experience a smoking ban while incarcerated or in in-patient settings often relapse to smoking shortly after release or discharge. We found that although smoking bans alone do not promote cessation, multi-component interventions in combination with smoking bans can significantly increase cessation rates post-release/discharge provided they support participants during this time. CONCLUSIONS There is limited evidence to suggest tobacco bans alone in prison, mental health and substance use treatment settings are effective in achieving long-term smoking cessation. This review suggests that combining smoking bans and cessation interventions including pre- and post-release/discharge support can be effective in achieving smoking cessation.
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Affiliation(s)
| | - Fran Hyslop
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Tony G Butler
- School of Population Health, UNSW Sydney, Sydney, Australia
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Wand H, Richmond R, Adily A, Le A, Wilhelm K, Butler T. Identifying significant contributors for smoking cessation among male prisoners in Australia: results from a randomised clinical trial. BMJ Open 2020; 10:e034046. [PMID: 32690730 PMCID: PMC7375500 DOI: 10.1136/bmjopen-2019-034046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION In Australia, an estimated 90% of those entering prison are current tobacco smokers and three-quarters of current prisoners are tobacco smokers. AIMS To identify factors and their relative contributions to smoking cessation among male prisoners. METHODS A total of 425 male tobacco smokers with a median age of 32 years in Australian prisons. The primary outcome was continuous abstinence at 3, 6 and 12 months. We measured various sociodemographic characteristics, drug use, psychological distress and the mental and physical health status of the participants. Multivariate logistic regression models and population attributable risks (PAR%) were used to identify the significant factors and their contributions to smoking cessation rates. RESULTS The median age of participants was 32 years (IQR 25-41 years). High smoking cessation rates were collectively associated with not using drugs, lower psychological distress, good mental health scores and better physical health (PAR%: 93%, 98% and 88% at 3, 6 and 12 months). CONCLUSION Our study suggests that not using drugs and being in good mental/physical health are the important contributors to continuous abstinence among prisoners. Thus, effective smoking cessation programmes require a multicomponent approach that includes addressing drug problems and mental health functioning. TRIAL REGISTRATION NUMBER 12606000229572.
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Affiliation(s)
- Handan Wand
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Robyn Richmond
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Armita Adily
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrea Le
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Kay Wilhelm
- School of Psychiatry, University of New South Wales, Sydney, Australila
| | - Tony Butler
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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5
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Puljević C, Segan CJ. Systematic Review of Factors Influencing Smoking Following Release From Smoke-Free Prisons. Nicotine Tob Res 2020; 21:1011-1020. [PMID: 29733380 DOI: 10.1093/ntr/nty088] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/30/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Given the current proliferation of prison smoke-free policies internationally, and the multiple benefits of continued smoking abstinence for correctional populations, improved understanding of factors influencing postrelease smoking abstinence is required to inform support strategies aimed at individuals exiting smoke-free prisons. METHODS We systematically searched health, social science, and criminal justice databases for studies relating to smoking behaviors among people released from smoke-free prisons. Studies were included if: they were published between January 1, 2000 and July 26, 2017; they were published in English; the population was people who were incarcerated or formerly incarcerated in prisons with total smoke-free policies; and the reported outcomes included measures of: (1) prerelease intention to smoke or remain abstinent from smoking following release, (2) smoking relapse or abstinence following release, or (3) quit attempts following postrelease smoking relapse. Both authors independently screened returned citations to assess eligibility and reviewed studies for methodological quality using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies. RESULTS Fifteen of 121 publications were included. The evidence base in this area is small, almost exclusively US-based, and is mostly methodologically weak. Interventions delivered both pre and postrelease, that strengthen intention to quit, integrate with other substance-use treatment, and facilitate social support for quitting may help maintain postrelease smoking abstinence. CONCLUSIONS There is an urgent need for high-quality research to inform interventions to reduce high smoking relapse rates upon release from smoke-free prisons, to extend the multiple benefits of continued smoking abstinence into the community. IMPLICATIONS Interventions designed to help people remain abstinent from tobacco following release from smoke-free prisons are an important opportunity to improve the health, finances, and well-being of this vulnerable population.
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Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia.,The Institute for Social Science Research, The University of Queensland, Brisbane, Australia
| | - Catherine J Segan
- Cancer Council Victoria, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Awooda EM, Shashati DE. Tobacco use among male inmates and their attitudes toward its prevention in Khartoum State: A cross-sectional study. Tob Prev Cessat 2019; 5:25. [PMID: 32411888 PMCID: PMC7205156 DOI: 10.18332/tpc/109784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/01/2019] [Accepted: 06/02/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tobacco use remains the most preventable cause of death and disability, with prisoners being a neglected population of tobacco users. The aim was to determine the prevalence of tobacco use and attitudes toward its prevention among adult male prisoners. METHODS We conducted a descriptive cross-sectional study among 349 adult male inmates from three prisons in Khartoum State. The interview questionnaire included questions related to tobacco use status, type of tobacco used, previous attempts to quit, smoking inside a room, frequency of tobacco use before and after incarceration, and attitude toward its prevention. Chi-squared and paired t-test were used to compare between different variables, with the level of significance set at p≤0.05. RESULTS The majority (69.1%) were in the age group 30-50 years. All of the studied prisoners were tobacco users of which: 43.8% used oral snuff (toombak); 22.1% were cigarette smokers; 30.9% used both cigarette and toombak; 0.6% used cigarette and waterpipe; and 3.2% used cigarette, toombak and waterpipe. Toombak users (alone or with other types of tobacco) were 272 (78%) with the majority (62.4%) dipping 2-5 times per day. There were 96 (57%) cigarette smokers (alone or with other types), and waterpipe users were 12 (3.8%). The majority (74.6%) of cigarette users shared their cell with other toombak users. For the majority (79.6%), the number of cigarettes and snuff dipping per day was directly proportional to the period of incarceration. Almost all (99.1%) prisoners know the harmful effects of tobacco use, and 64.5% had previously attempted to quit. Also, 98% of tobacco users reported a desire to quit and expressed willingness to participate in a tobacco-cessation program. CONCLUSIONS Different patterns and methods of tobacco use were explored, and all the studied prisoners were users. Tobacco use increased after incarceration. The willingness to participate in tobacco-cessation counselling should be met with the implementation of a planned and well-designed prevention program.
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Affiliation(s)
- Elhadi M. Awooda
- Department of Restorative Dentistry, University of Medical Science and Technology, Khartoum, Sudan
| | - Dina E. Shashati
- Department of Restorative Dentistry, University of Medical Science and Technology, Khartoum, Sudan
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Puljević C, Coomber R, de Andrade D, Kinner SA. Barriers and facilitators of maintained smoking abstinence following release from smoke-free prisons: A qualitative enquiry. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 68:9-17. [PMID: 30974331 DOI: 10.1016/j.drugpo.2019.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 01/24/2019] [Accepted: 03/11/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND The prevalence of smoking among people entering prisons is high. Despite increasing adoption of prison smoke-free policies, relapse to smoking after release from prison is nearly universal, and policy to effectively mitigate this is largely absent. Informed by a risk environment framework, we aimed to identify key barriers and facilitators to maintaining smoking abstinence among former smokers released from smoke-free prisons. METHOD Twenty-one people released from smoke-free prisons in Queensland, Australia, were followed up from a larger survey of 114 former prisoners. Semi-structured interviews were used to explore the perceived barriers and facilitators of maintained smoking abstinence. FINDINGS Identified barriers to continued abstinence included pre-release intention to resume smoking; normalisation of smoking in home or social environments, resumption of smoking as a symbolic act of freedom and resistance from and to a restrictive environment; a perception that smoking provides stress relief to their difficult lives, and the use of tobacco/smoking to cope with cravings experienced on release for illicit substances. A number of interviewees were unable to provide clear reflective reasons for relapse. For those who did manage to remain abstinent for a period of time, identified facilitators included an awareness of the health and financial benefits of smoking abstinence, the use of intrinsic motivation, distraction from nicotine cravings using alternative activities, and social support from family and peers. DISCUSSION Interventions promoting continued smoking abstinence among people exiting smoke-free prisons should focus on targeting the perceived individual- and environmental-level barriers to maintained smoking abstinence while simultaneously promoting perceived facilitators, so as to reduce smoking-related health and economic disparities in this marginalised population.
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Affiliation(s)
- Cheneal Puljević
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia; Griffith Criminology Institute, Griffith University, Brisbane, Australia.
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, Brisbane, Australia; Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, United Kingdom; School of Justice, Queensland University of Technology, Brisbane, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, Brisbane, Australia; Lives Lived Well Research Group, School of Psychology, The University of Queensland, Brisbane, Australia; Centre for Youth Substance Abuse Research, School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne Australia; Mater Research Institute-UQ, The University of Queensland, Brisbane, Australia
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Puljević C, Coomber R, Kinner SA, de Andrade D, Mitchell C, White A, Cresswell SL, Bowman J. 'Teabacco': Smoking of nicotine-infused tea as an unintended consequence of prison smoking bans. Drug Alcohol Rev 2018; 37:912-921. [PMID: 30051520 DOI: 10.1111/dar.12848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/21/2018] [Accepted: 06/29/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION AND AIMS Following the introduction of smoke-free policies in prisons in several countries, there have been anecdotal reports of prisoners creating cigarettes by mixing nicotine patches or lozenges with tea leaves ('teabacco'). Among a sample of people recently released from smoke-free prisons in Queensland, Australia, the aims of this study were to explore the perceived popularity of teabacco use, motivations for its use and describe the process of creating teabacco to identify potential associated health risks. DESIGN AND METHODS This study used a mixed-methods design. Eighty-two people recently released from prison in Queensland, Australia completed surveys at parole offices measuring teabacco use while incarcerated. Twenty-one teabacco smokers took part in follow-up, qualitative interviews to explore survey responses in greater depth. RESULTS The majority of survey participants (57%) reported smoking teabacco while incarcerated, with 37% smoking teabacco frequently (> once per week). Teabacco use was primarily motivated by cigarette cravings. Participants described the perceived inevitability of prisoners finding substitutes for tobacco. Multivariate analyses found that self-rated poor physical health, having been incarcerated five or more times, experiencing cigarette cravings while incarcerated, and use of illicit drugs while incarcerated were positively associated with frequent teabacco use in prison. DISCUSSION AND CONCLUSIONS Our findings suggest that teabacco use has become common practice in Queensland's smoke-free prisons. Correctional smoking bans are an important public health initiative but should be complemented with demand and harm reduction measures cognisant of the risk environment.
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Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia.,The Institute for Social Science Research, The University of Queensland, Brisbane, Australia
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, UK
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Mater Research Institute-UQ, University of Queensland, Brisbane, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,School of Psychology, University of Queensland, Brisbane, Australia.,Centre for Youth Substance Abuse Research, School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Courtney Mitchell
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Alan White
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Sarah L Cresswell
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Jasper Bowman
- School of Environment and Science, Griffith University, Brisbane, Australia
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Breaking Free from Smoking: A Novel Digital Smoking Cessation Intervention for Offenders in UK Prisons. J Smok Cessat 2018. [DOI: 10.1017/jsc.2018.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction: The level of smoking cessation support across UK prisons is variable, with most offering pharmacological support, such as nicotine replacement therapy. However, with a complete smoking ban in prisons in England now imminent, additional standardised behavioural support is necessary to help offenders go smoke-free.Aims: This study used the Behaviour Change Wheel to aim to develop the content of an online smoking cessation intervention for offenders, with consideration of their capability, motivation and opportunity for behaviour change.Methods: This was an intervention development study. The Behaviour Change Wheel was used to map cognitive, behavioural, physiological and social targets for the intervention, onto appropriate intervention techniques for inclusion in the smoking cessation programme for offenders.Results: Psychological capability, social opportunity and reflective and automatic motivation were identified through deductive thematic analysis as areas of change required to achieve smoking cessation. A total of 27 behavioural change techniques were chosen for this smoking cessation intervention and were mapped onto the Lifestyle Balance Model which provided the theoretical basis on which the components of the programme are conceptualised. This included strategies around increasing motivation to quit, anticipating smoking triggers, modifying smoking-related thoughts, regulating emotions, managing cravings, replacing smoking and rewarding nicotine abstinence and adopting a healthier lifestyle.Conclusions: Through the utilisation of the Behaviour Change Wheel, the development process of this digital smoking cessation intervention was achieved. Further research is planned to evaluate the clinical effectiveness of this intervention and to explore how the programme is implemented in practice within prison settings.
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Liber AC, Warner KE. Has Underreporting of Cigarette Consumption Changed Over Time? Estimates Derived From US National Health Surveillance Systems Between 1965 and 2015. Am J Epidemiol 2018; 187:113-119. [PMID: 28595348 DOI: 10.1093/aje/kwx196] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 03/02/2017] [Indexed: 11/12/2022] Open
Abstract
According to survey data, the prevalence of Americans' self-reported cigarette smoking is dropping steadily. However, the accuracy of national surveys has been questioned because of declining response rates and the increasing stigmatization of smoking. We used data from 2 repeated, cross-sectional, nationally representative health surveys (National Survey on Drug Use and Health (NSDUH), 1979-2014; and National Health Interview Survey (NHIS), 1965-2015) to determine whether self-reported cigarette consumption has changed over time as a proportion of federally taxed cigarette sales. From each survey, we calculated national equivalents of annual cigarette consumption. From 1979 to 1997, the amount of cigarettes that NSDUH and NHIS respondents reported corresponded to an average of 59.5% (standard deviation (SD), 2.3%) and 65.6% (SD, 3.2%), respectively, of taxed cigarette sales. After 1997, respondents' reported smoking data corresponded to the equivalent of an average of 64.2% (SD, 5.9%) and 63.3% (SD, 2.5%), respectively, of taxed cigarette sales. NHIS figures remained steady throughout the latter period, with a decline during 2013-2015 from 65.9% to 61.1%. NSDUH figures increased steadily, exceeding those of the NHIS after 2002. Given the consistent underreporting of cigarette consumption over time, these surveys are likely not less accurate than they were previously. The recent decrease in NHIS accuracy, however, gives pause about the magnitude of the reported decline in smoking prevalence in 2014 and 2015. Improvement in the accuracy of NSDUH data is encouraging.
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Affiliation(s)
- Alex C Liber
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan
- Economic and Health Policy Research, Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Kenneth E Warner
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan
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Puljević C, Kinner SA, de Andrade D. Extending smoking abstinence after release from smoke-free prisons: protocol for a randomised controlled trial. HEALTH & JUSTICE 2017; 5:1. [PMID: 28116579 PMCID: PMC5256626 DOI: 10.1186/s40352-016-0046-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/28/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND A smoking ban was implemented across all prisons in Queensland, Australia, in May 2014, with the aim of improving the health of prisoners and prison staff. However, relapse to smoking after release from prison is common. Only one previous study, conducted in the United States, has used a randomised design to evaluate an intervention to assist individuals in remaining abstinent from smoking following release from a smoke-free prison. METHODS This paper describes the rationale for and design of a randomised controlled trial of an intervention to extend smoking abstinence in men after release from smoke-free prisons in the state of Queensland, Australia. Participants in the intervention group will receive a brief intervention involving four group sessions of motivational interviewing and cognitive behavioural therapy, initiated 4 weeks prior to release from prison. The comparison group will receive a pamphlet and brief verbal intervention at the time of baseline assessment. Assessment of self-reported, post-release smoking status will be conducted by parole officers at regular parole meetings with the primary outcome measured at 1 month post release. DISCUSSION The prevalence of smoking and related health harms among people who experience incarceration is extremely high. Effective interventions that result in long-term smoking cessation are needed to reduce existing health disparities in this vulnerable population. TRIAL REGISTRATION Current Controlled Trials ACTRN12616000314426.
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Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Mater Research Institute, University of Queensland, Brisbane, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- Centre for Youth Substance Abuse Research, Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
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Puljević C, de Andrade D, Carroll M, Spittal MJ, Kinner SA. Use of prescribed smoking cessation pharmacotherapy following release from prison: a prospective data linkage study. Tob Control 2017; 27:474-478. [PMID: 28848000 DOI: 10.1136/tobaccocontrol-2017-053743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/20/2017] [Accepted: 08/02/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND A significant proportion of people who cycle through prisons express a desire to quit smoking, yet smoking rates in this population are two to four times higher than in the general community. Smoking cessation pharmacotherapy (SCP) is an important component of evidence-based cessation support, yet no studies have examined use of this pharmacotherapy after release from prison. METHODS We linked data from a survey of 971 smokers who were within 8 weeks of release from prison in Queensland, Australia, with federal Pharmaceutical Benefits Scheme (PBS) records for the 2 years after release, to identify subsidised use of SCP (varenicline, bupropion and nicotine patches). We used Cox proportional hazards regression to identify independent predictors of SCP use. FINDINGS According to PBS data, 86 participants (8.9%) accessed SCP in the 2 years following release from prison. Participants who were aged 25 years or older (HR 2.51, 95% CI 1.19 to 5.31), employed before prison (HR 1.93, 95% CI 1.14 to 3.28), highly nicotine dependent at baseline (HR 2.21, 95% CI 1.23 to 3.97) and using non-psychotropic medications in prison (HR 2.29, 95% CI 1.24 to 4.22) were more likely to use subsidised SCP during follow-up. CONCLUSION Despite a very high rate of tobacco use among people cycling through prisons and the very low cost of (subsidised) SCP in Australia, few ex-prisoners obtain pharmaceutical assistance with quitting smoking. Policy attention needs to focus on supporting former prisoners to access SCP, to reduce the high rate of tobacco-related morbidity and mortality in this profoundly marginalised population.
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Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Centre for Youth Substance Abuse Research, School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Megan Carroll
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Sydney, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia.,Mater Research Institute-UQ, University of Queensland, Queensland, Australia
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13
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Krebs NM, Allen SI, Veldheer S, Martinez DJ, Horn K, Livelsberger C, Modesto J, Kuprewicz R, Wilhelm A, Hrabovsky S, Kazi A, Fazzi A, Liao J, Zhu J, Wasserman E, Reilly SM, Reinhart L, Trushin N, Moyer RE, Bascom R, Foulds J, Richie JP, Muscat JE. Reduced nicotine content cigarettes in smokers of low socioeconomic status: study protocol for a randomized control trial. Trials 2017; 18:300. [PMID: 28673312 PMCID: PMC5496140 DOI: 10.1186/s13063-017-2038-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/01/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The Family Smoking Prevention and Tobacco Control Act gave the Food and Drug Administration jurisdiction over the regulation of all tobacco products, including their nicotine content. Under this act, a major strategy to reduce harm from cigarette tobacco is lowering the nicotine content without causing unintended adverse consequences. Initial research on reduced nicotine content (RNC) cigarettes has shown that smokers of these cigarettes gradually decrease their smoking frequency and biomarkers of exposure. The effectiveness of this strategy needs to be demonstrated in different populations whose response to RNC cigarettes might be substantially mediated by personal or environmental factors, such as low socioeconomic status (SES) populations. This study aims to evaluate the response to a reduced nicotine intervention in low SES smokers, as defined here as those with less than 16 years of education, by switching smokers from high nicotine commercial cigarettes to RNC cigarettes. METHODS/DESIGN Adults (N = 280) who have smoked five cigarettes or more per day for the past year, have not made a quit attempt in the prior month, are not planning to quit, and have less than 16 years of education are recruited into a two-arm, double-blinded randomized controlled trial. First, participants smoke their usual brand of cigarettes for 1 week and SPECTRUM research cigarettes containing a usual amount of nicotine for 2 weeks. During the experimental phase, participants are randomized to continue smoking SPECTRUM research cigarettes that contain either (1) usual nicotine content (UNC) (11.6 mg/cigarette) or (2) RNC (11.6 to 0.2 mg/cigarette) over 18 weeks. During the final phase of the study, all participants are offered the choice to quit smoking with nicotine replacement therapy, continue smoking the research cigarettes, or return to their usual brand of cigarettes. The primary outcomes of the study include retention rates and compliance with using only research cigarettes and no use of other nicotine-containing products. Secondary outcomes are tobacco smoke biomarkers, nicotine dependence measures, smoking topography, stress levels, and adverse health consequences. DISCUSSION Results from this study will provide information on whether low SES smokers can maintain a course of progressive nicotine reduction without increases in incidence of adverse effects. TRIAL REGISTRATION ClinicalTrials.gov, NCT01928719 . Registered on 21 August 2013.
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Affiliation(s)
- Nicolle M. Krebs
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Sophia I. Allen
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Susan Veldheer
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Diane J. Martinez
- The Milken School of Public Health, George Washington University, 950 New Hampshire Ave. NW, Washington, D.C, 20052 USA
| | - Kimberly Horn
- The Milken School of Public Health, George Washington University, 950 New Hampshire Ave. NW, Washington, D.C, 20052 USA
| | - Craig Livelsberger
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Jennifer Modesto
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Robin Kuprewicz
- The Milken School of Public Health, George Washington University, 950 New Hampshire Ave. NW, Washington, D.C, 20052 USA
| | - Ashley Wilhelm
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Shari Hrabovsky
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Abid Kazi
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Alyse Fazzi
- Investigational Drug Service, Department of Pharmacy, Pennsylvania State University, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Jason Liao
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Junjia Zhu
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Emily Wasserman
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Samantha M. Reilly
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Lisa Reinhart
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Neil Trushin
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Robinn E. Moyer
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Rebecca Bascom
- Department of Medicine, Pennsylvania State University, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - John P. Richie
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
| | - Joshua E. Muscat
- Department of Public Health Sciences, Penn State Tobacco Center of Regulatory Science, Pennsylvania State University, MC CH69, 500 University Drive, P.O. Box 850, Hershey, PA 17033 USA
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Abera SF, Adane K. Burden and Determinants of Smoking among Prisoners with Respiratory Tract Infection: A Cross-Sectional Study of Nine Major Prison Setups in Northern Ethiopia. PLoS One 2016; 11:e0168941. [PMID: 28030604 PMCID: PMC5193439 DOI: 10.1371/journal.pone.0168941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 12/08/2016] [Indexed: 11/22/2022] Open
Abstract
Background Morbidity, mortality and a wide range of associated risk factors are disproportionately clustered among prisoners compared to the general population. Smoking is one of the risk factors for the increased burden of unfavorable health outcomes particularly among prisoners. However, little is known about the level and determinants of smoking among the incarcerated population in Ethiopia. Methods We collected data from 738 prisoners in nine major prison setups in Tigray region by nurses and clinical officers. Data were entered in to Epi Data 3.1 and exported to stata 13.0 for cleaning and further analysis. Multivariable logistic regression model was fitted to identify determinants of smoking at p value of less than 5%. Result The prevalence of smoking was 21 per cent (95%CI = 18.2%, 24.1). Urban residence (AOR = 2.15; 95%CI = 1.20, 3.84), previous history of incarceration (AOR = 1.91; 95%CI = 1.08, 3.40) and alcohol use before incarcerated (AOR = 4.20; 95%CI = 2.57, 6.87) were significantly associated with risk of smoking. In contrast, risk of smoking was significantly lower for farmers (AOR = 0.20; 95% CI = 0.08, 0.49), prisoners with family support (AOR = 0.52; 95% CI = 0.32, 0.87) and for those who were jailed in Shire prison site (AOR = 0.43; 95%CI = 0.20, 0.95). Conclusion Our work clearly indicates that the observed smoking prevalence calls for the need of comprehensive and interdisciplinary interventions targeting prisoners.
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Affiliation(s)
- Semaw Ferede Abera
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
- Kilte Awlaelo Health and Demographic Surveillance Site, Mekelle, Ethiopia
- * E-mail:
| | - Kelemework Adane
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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15
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de Andrade D, Kinner SA. Systematic review of health and behavioural outcomes of smoking cessation interventions in prisons. Tob Control 2016; 26:495-501. [PMID: 27798322 PMCID: PMC5574402 DOI: 10.1136/tobaccocontrol-2016-053297] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/13/2016] [Accepted: 09/26/2016] [Indexed: 01/06/2023]
Abstract
Objective We conducted a systematic review to examine the impact of smoking cessation interventions, including smoking bans, on prisoners and prison staff. Data sources We systematically searched health and criminal justice databases for relevant studies. Search strings were used to combine terms related to smoking cessation interventions with terms related to incarceration. We used forward and backward snowballing to capture additional studies. Study selection Studies were included if: they were published between 1 January 1994 and 23 May 2016; the population was incarcerated adults and/or prison staff; they had a quantitative component; they were published in English; and they reported outcomes of a smoking cessation programme/ban with regard to reported change in smoking behaviour and/or behavioural outcomes. Data extraction Studies were reviewed for methodological rigour using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies. Data were independently reviewed for methodological quality by 1 author and a research assistant. Data synthesis Cessation programmes, including free nicotine replacement therapy and/or behavioural counselling can significantly increase the likelihood of quitting in prison and increase abstinence postrelease. Indoor bans have little impact on prisoner smoking behaviour. Prisoners who experience a complete smoking ban typically resume smoking shortly after release from prison. Bans may result in adverse behavioural outcomes, but these are generally minimal and short-lived. Conclusions While there is limited evidence to inform tobacco control policies in custodial settings, outcomes of this review suggest that cessation programmes/bans can be an effective mechanism to interrupt prisoner smoking behaviour when properly enforced.
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Affiliation(s)
- Dominique de Andrade
- Griffith Criminology Institute and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Stuart A Kinner
- Griffith Criminology Institute and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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16
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Vijayaraghavan M, Schroeder SA, Kushel M. The effectiveness of tobacco control policies on vulnerable populations in the USA: a review. Postgrad Med J 2016; 92:670-676. [DOI: 10.1136/postgradmedj-2014-133193] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/24/2016] [Accepted: 08/27/2016] [Indexed: 11/04/2022]
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17
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He C, Knibbs LD, Tran Q, Wang H, Laiman R, Wang B, Gu Y, Morawska L. Unexpected increase in indoor pollutants after the introduction of a smoke-free policy in a correctional center. INDOOR AIR 2016; 26:623-633. [PMID: 26182955 DOI: 10.1111/ina.12238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 07/09/2015] [Indexed: 06/04/2023]
Abstract
Correctional centers (prisons) are one of the few non-residential indoor environments where smoking is still permitted. However, few studies have investigated indoor air quality (IAQ) in these locations. We quantified the level of inmate and staff exposure to secondhand smoke, including particle number (PN) count, and we assessed the impact of the smoking ban on IAQ. We performed measurements of indoor and outdoor PM2.5 and PN concentrations, personal PN exposure levels, volatile organic compounds (VOCs), and nicotine both before and after a complete indoor smoking ban in an Australian maximum security prison. Results show that the indoor 24-h average PM2.5 concentrations ranged from 6 (±1) μg/m(3) to 17 (±3) μg/m(3) pre-ban. The post-ban levels ranged from 7 (±2) μg/m(3) to 71 (±43) μg/m(3) . While PM2.5 concentrations decreased in one unit post-ban, they increased in the other two units. Similar post-ban increases were also observed in levels of PN and VOCs. We describe an unexpected increase of indoor pollutants following a total indoor smoking ban in a prison that was reflected across multiple pollutants that are markers of smoking. We hypothesise that clandestine post-ban smoking among inmates may have been the predominant cause.
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Affiliation(s)
- C He
- International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - L D Knibbs
- International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Qld, Australia
- School of Population Health, The University of Queensland, Herston, Qld, Australia
| | - Q Tran
- International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Qld, Australia
- Faculty of Environmental Engineering, National University of Civil Engineering, Hanoi, Vietnam
| | - H Wang
- International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Qld, Australia
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - R Laiman
- International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - B Wang
- Department of Environmental Engineering, Jinan University, Guangzhou, China
| | - Y Gu
- Department of Environmental Engineering, Jinan University, Guangzhou, China
| | - L Morawska
- International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Qld, Australia
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18
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Frazer K, McHugh J, Callinan JE, Kelleher C. Impact of institutional smoking bans on reducing harms and secondhand smoke exposure. Cochrane Database Syst Rev 2016:CD011856. [PMID: 27230795 PMCID: PMC10164285 DOI: 10.1002/14651858.cd011856.pub2] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Smoking bans or restrictions can assist in eliminating nonsmokers' exposure to the dangers of secondhand smoke and can reduce tobacco consumption amongst smokers themselves. Evidence exists identifying the impact of tobacco control regulations and interventions implemented in general workplaces and at an individual level. However, it is important that we also review the evidence for smoking bans at a meso- or organisational level, to identify their impact on reducing the burden of exposure to tobacco smoke. Our review assesses evidence for meso- or organisational-level tobacco control bans or policies in a number of specialist settings, including public healthcare facilities, higher education and correctional facilities. OBJECTIVES To assess the extent to which institutional smoking bans may reduce passive smoke exposure and active smoking, and affect other health-related outcomes. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE, EMBASE, and the reference lists of identified studies. We contacted authors to identify completed or ongoing studies eligible for inclusion in this review. We also checked websites of state agencies and organisations, such as trial registries. Date of latest searches was 22nd June 2015. SELECTION CRITERIA We considered studies that reported the effects of tobacco bans or policies, whether complete or partial, on reducing secondhand smoke exposure, tobacco consumption, smoking prevalence and other health outcomes, in public healthcare, higher educational and correctional facilities, from 2005 onwards.The minimum standard for inclusion was having a settings-level policy or ban implemented in the study, and a minimum of six months follow-up for measures of smoking behaviour. We included quasi-experimental studies (i.e. controlled before-and-after studies), interrupted time series as defined by the Cochrane Effective Practice and Organization of Care Group, and uncontrolled pre- and post-ban data. DATA COLLECTION AND ANALYSIS Two or more review authors independently assessed studies for inclusion in the review. Due to variation in the measurement of outcomes we did not conduct a meta-analysis for all of the studies included in this review, but carried out a Mantel-Haenszel fixed-effect meta-analysis, pooling 11 of the included studies. We evaluated all studies using a qualitative narrative synthesis. MAIN RESULTS We included 17 observational studies in this review. We found no randomized controlled trials. Twelve studies are based in hospitals, three in prisons and two in universities. Three studies used a controlled before-and-after design, with another site used for comparison. The remaining 14 studies used an uncontrolled before-and-after study design. Five studies reported evidence from two participant groups, including staff and either patients or prisoners (depending on specialist setting), with the 12 remaining studies investigating only one participant group.The four studies (two in prisons, two in hospitals) providing health outcomes data reported an effect of reduced secondhand smoke exposure and reduced mortality associated with smoking-related illnesses. No studies included in the review measured cotinine levels to validate secondhand smoke exposure. Eleven studies reporting active smoking rates with 12,485 participants available for pooling, but with substantial evidence of statistical heterogeneity (I² = 72%). Heterogeneity was lower in subgroups defined by setting, and provided evidence for an effect of tobacco bans on reducing active smoking rates. An analysis exploring heterogeneity within hospital settings showed evidence of an effect on reducing active smoking rates in both staff (risk ratio (RR) 0.71, 95% confidence interval ( CI) 0.64 to 0.78) and patients (RR 0.86, 95% CI 0.76 to 0.98), but heterogeneity remained in the staff subgroup (I² = 76%). In prisons, despite evidence of reduced mortality associated with smoking-related illnesses in two studies, there was no evidence of effect on active smoking rates (1 study, RR 0.99, 95% CI 0.84 to 1.16).We judged the quality of the evidence to be low, using the GRADE approach, as the included studies are all observational. AUTHORS' CONCLUSIONS We found evidence of an effect of settings-based smoking policies on reducing smoking rates in hospitals and universities. In prisons, reduced mortality rates and reduced exposure to secondhand smoke were reported. However, we rated the evidence base as low quality. We therefore need more robust studies assessing the evidence for smoking bans and policies in these important specialist settings.
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Affiliation(s)
- Kate Frazer
- School of Nursing, Midwifery & Health Systems, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland
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Kennedy SM, Sharapova SR, Beasley DD, Hsia J. Cigarette Smoking Among Inmates by Race/Ethnicity: Impact of Excluding African American Young Adult Men From National Prevalence Estimates. Nicotine Tob Res 2016; 18 Suppl 1:S73-8. [PMID: 26980867 PMCID: PMC5100810 DOI: 10.1093/ntr/ntv157] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Cigarette smoking prevalence is more than two times greater among incarcerated adults, a population usually excluded from national health surveys. African American young adult (18-25) men are less likely to smoke cigarettes than their white counterparts. However, they are two and a-half-times more likely to be incarcerated. This study estimated smoking prevalence with noninstitutionalized and incarcerated samples combined to determine if excluding incarcerated adults impacts smoking prevalence for certain populations. METHODS The Bureau of Justice Statistics last fielded the Survey of Inmates in State and Federal Correction Facilities in 2003-2004. We combined data from Survey of Inmates in State and Federal Correction Facilities (n = 17 910) and the 2003 and 2004 National Health Interview Survey (n = 61 470) to calculate combined cigarette smoking estimates by race/ethnicity, sex, and age. RESULTS Inmates represented the greatest proportion of smokers among African American men. Among African American young adult men, inmates represented 15.2% of all smokers in the combined population, compared to 2.0% among white young adult men. Cigarette smoking prevalence was 17.6% in the noninstitutionalized population of young adult African American men and 19.7% in the combined population. Among white young adult men, cigarette smoking prevalence was 29.8% in the noninstitutionalized population, and 30.2% in the combined population. There was little difference in estimates among women. CONCLUSIONS The exclusion of incarcerated African American young adult men may result in a small underestimation of cigarette smoking prevalence in this population. Increasing access to smoking cessation support among inmates may reduce smoking prevalence in disproportionately incarcerated segments of the US population. IMPLICATIONS The exclusion of incarcerated adults from national survey data should be considered when examining differences in cigarette smoking prevalence estimates between African American and white young adult men. Approximately one in six African American young adult men who smoke were incarcerated. Increasing access to smoking cessation support among inmates may reduce smoking prevalence among disproportionately incarcerated segments of the population.
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Affiliation(s)
- Sara M Kennedy
- Biostatistics and Epidemiology Division, RTI International, Atlanta, GA;
| | - Saida R Sharapova
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Jason Hsia
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
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Tobacco Use Among People Who Have Been in Prison: Relapse and Factors Associated with Trying to Quit. J Smok Cessat 2016; 12:76-85. [PMID: 29430256 DOI: 10.1017/jsc.2016.3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction Tobacco use is common among people who have been in prison. The relationship between social stressors, risky health behaviours, and smoking cessation has not been studied in people recently released from prison. Studying this relationship could yield information that guides strategic and cost-effective tobacco cessation interventions for an under-resourced population. Methods One hundred and forty-three smokers were interviewed 7 to 21 days after they had been released from USA prisons. Independent variables included employment status, housing security, relationship problems, educational achievement, risky drinking behaviour, recent drug use, history of drug dependence, and depression. The primary outcome was 'trying to quit smoking.' Data were analysed using Pearson chi-square tests and single and multivariable logistic regression models. Results Of those who had to quit smoking due to tobacco-free prison policies, 98% reported relapsing on tobacco after release. Trying to quit smoking was associated with the absence of risky drinking behaviour in the past 30 days (adjusted odds ratio [AOR] 6.44, 95% confidence interval [CI] 2.02-20.48). Conclusions The absence of risky drinking behaviour is associated with trying to quit smoking among people recently released from prison. Further research may determine whether interventions addressing risky alcohol use can reduce smoking relapse.
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Pires SF, Block S, Belance R, Marteache N. The spatial distribution of smoking violations on a no-smoking campus: Implications for prevention. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2016; 64:62-68. [PMID: 26495865 DOI: 10.1080/07448481.2015.1074239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The present study extends research on campus smoking bans by examining where smokers are violating the policy at a large university in the southeastern region of the United States. PARTICIPANTS The data collection was conducted by one graduate student from the university in August of 2014. METHODS A global positioning system device was used to collect the geo-coordinates of littered cigarette butts as a proxy measure for smoking violations. RESULTS A hot spot analysis found a number of spatial concentrations on campus, largely around classroom and administrative buildings along with parking lots and garages. CONCLUSIONS The implications of such findings can direct enforcement to target these areas in order to reduce offenses and fulfill the initial goals of policy-makers and university administrators who support smoke-free campuses.
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Affiliation(s)
- Stephen F Pires
- a Department of Criminal Justice , Florida International University , Miami , Florida , USA
| | - Steven Block
- b Department of Criminology and Criminal Justice , Central Connecticut State University , New Britain , Connecticut , USA
| | - Ronald Belance
- a Department of Criminal Justice , Florida International University , Miami , Florida , USA
| | - Nerea Marteache
- c Department of Criminal Justice , California State University, San Bernardino , San Bernardino , California , USA
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Abstract
INTRODUCTION Smoking, with a prevalence ranging from 42% to 91%, and secondhand smoke (SHS), with a high exposure level of 3 to 11 μg/m, are frequently seen in prisons. OBJECTIVES We aimed at investigating the prevalence of chronic obstructive pulmonary disease (COPD) among inmates and prison staff. MATERIAL AND METHODS This study included prisoners and prison staff in Bolvadin Closed and Open Prison in Turkey. All volunteers went through a standard spirometry and completed the Fagerstrom Test for nicotine dependence. RESULTS A total of 179 volunteers, 109 of whom were prisoners and 70 prison staff, were involved in the study. Average age was 35.6 ± 11.9 years. There were 123 smokers (68.7%), 26 ex-smokers (14.5%), and 30 nonsmokers (16.8%). Up to 89.4% of participants reported that they were exposed to SHS. Mean forced expiratory volume in 1 second (FEV1) value was found to be 3.68 ± 0.80 (93.9 ± 15.1%), forced vital capacity (FVC) value to be 3.87 ± 0.83 (83.1 ± 14.3%), and FEV1/FVC to be 98.4 ± 19.6. Eighteen inmates and 2 prison staff members had the diagnosis of COPD; 22 prisoners (20.2%) and 4 prison staff members (5.7%) had COPD. There were pulmonary symptoms in 49.2% of the volunteers; the symptoms were statistically higher in smokers when compared to non-smokers and ex-smokers (P = 0.000). There was a statistically significant relationship between exposure to SHS and presence of COPD (P = 0.043), and pulmonary symptoms (P = 0.008). CONCLUSIONS The frequency of smoking in this prison was considerably high (68.7%, compared against 22%-31% in non-incarcerated populations). The prevalence of COPD was also found high among inmates (20.2% vs 4.2%-23% in non-incarcerated populations). Therefore, pulmonary symptoms should be examined carefully when screening prisoners, including consideration for the use of lung spirometry and screening for tobacco use disorder.
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Howell BA, Guydish J, Kral AH, Comfort M. Prevalence and factors associated with smoking tobacco among men recently released from prison in California: A cross-sectional study. Addict Behav 2015; 50:157-60. [PMID: 26150399 DOI: 10.1016/j.addbeh.2015.06.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 05/03/2015] [Accepted: 06/04/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Over 1.5 million people are incarcerated in state and federal correctional facilities in the United States. Formerly incarcerated men have significantly higher rates of mortality and morbidity than the general population, disparities that have been partially attributed to higher rates of tobacco smoking-related illnesses such as cardiovascular disease, pulmonary disease and cancer. METHODS We compared the prevalence of smoking tobacco in a sample of 172 men who were released from California state prisons to Oakland and San Francisco between 2009 and 2011 to sub-populations of respondents to the 2009 California Health Interview Survey (CHIS). Using logistic regression, we analyzed the association between lifetime history of incarceration and self-reported smoking status. RESULTS Seventy-four percent of men recently released from prison reported being current tobacco smokers. The prevalence of smoking in a demographically similar group of men in the CHIS was 24%. We found in bivariate analysis that each additional five years of history of incarceration was associated with 1.32 times greater odds of smoking (95% CI 1.02 to 1.71). Illicit substance use was associated with a 2.47 higher adjusted odds of smoking (95% CI 1.29 to 5.39). In the multivariate model adjusting for age, income, substance use and mental health, every five years of incarceration was associated with 1.23 greater odds of smoking (95% CI 0.94 to 1.63) which was not statistically significant. CONCLUSIONS Given the high prevalence of smoking tobacco among former prisoners and the underlying high tobacco-related mortality rates, these findings suggest that a history of incarceration may be an important determinant of smoking. Prison and parole systems may be important potential settings for smoking-cessation interventions.
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Affiliation(s)
- Benjamin A Howell
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Joseph Guydish
- Philip R Lee Health Policy Institute, University of San Francisco, San Francisco, CA, USA
| | - Alex H Kral
- Behavioral and Urban Health Program, RTI International, San Francisco, CA, USA
| | - Megan Comfort
- Behavioral and Urban Health Program, RTI International, San Francisco, CA, USA.
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Bailey ZD, Okechukwu C, Kawachi I, Williams DR. Incarceration and Current Tobacco Smoking Among Black and Caribbean Black Americans in the National Survey of American Life. Am J Public Health 2015; 105:2275-82. [PMID: 26378842 DOI: 10.2105/ajph.2015.302772] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the relationship between having a history of incarceration and being a current smoker using a national sample of noninstitutionalized Black adults living in the United States. METHODS With data from the National Survey of American Life collected between February 2001 and March 2003, we calculated individual propensity scores for having a history of incarceration. To examine the relationship between prior incarceration and current smoking status, we ran gender-specific propensity-matched fitted logistic regression models. RESULTS A history of incarceration was consistently and independently associated with a higher risk of current tobacco smoking in men and women. Formerly incarcerated Black men had 1.77 times the risk of being a current tobacco smoker than did their counterparts without a history of incarceration (95% confidence interval [CI] = 1.20, 2.61) in the propensity score-matched sample. The results were similar among Black women (prevalence ratio = 1.61; 95% CI = 1.00, 2.57). CONCLUSIONS Mass incarceration likely contributes to the prevalence of smoking among US Blacks. Future research should explore whether the exclusion of institutionalized populations in national statistics obscures Black-White disparities in tobacco smoking.
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Affiliation(s)
- Zinzi D Bailey
- Zinzi D. Bailey, Cassandra Okechukwu, Ichiro Kawachi, and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Zinzi D. Bailey is also with the Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, Canada
| | - Cassandra Okechukwu
- Zinzi D. Bailey, Cassandra Okechukwu, Ichiro Kawachi, and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Zinzi D. Bailey is also with the Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, Canada
| | - Ichiro Kawachi
- Zinzi D. Bailey, Cassandra Okechukwu, Ichiro Kawachi, and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Zinzi D. Bailey is also with the Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, Canada
| | - David R Williams
- Zinzi D. Bailey, Cassandra Okechukwu, Ichiro Kawachi, and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Zinzi D. Bailey is also with the Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, Canada
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Kennedy SM, Davis SP, Thorne SL. Smoke-free policies in U.S. Prisons and jails: A review of the literature. Nicotine Tob Res 2015; 17:629-35. [PMID: 25475088 PMCID: PMC4634865 DOI: 10.1093/ntr/ntu225] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 10/08/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Despite progress in limiting exposure to secondhand smoke (SHS) in the United States, little is known about the impact of smoke-free polices in prisons and jails. SHS exposure in this setting may be great, as smoking prevalence among inmates is more than three times higher than among non-incarcerated adults. To inform the implementation of smoke-free policies, this article reviews the literature on the extent, nature, and impact of smoke-free policies in U.S. prisons and jails. METHODS We systematically searched PubMed, Embase, EconLit, and Social Services Abstracts databases. We examined studies published prior to January 2014 that described policies prohibiting smoking tobacco in adult U.S. correctional facilities. RESULTS Twenty-seven studies met inclusion criteria. Smoke-free policies in prisons were rare in the 1980s but, by 2007, 87% prohibited smoking indoors. Policies reduced SHS exposure and a small body of evidence suggests they are associated with health benefits. We did not identify any studies documenting economic outcomes. Non-compliance with policies was documented in a small number of prisons and jails, with 20%-76% of inmates reporting smoking in violation of a policy. Despite barriers, policies were implemented successfully when access to contraband tobacco was limited and penalties were enforced. CONCLUSION Smoke-free policies have become increasingly common in prisons and jails, but evidence suggests they are not consistently implemented. Future studies should examine the health and economic outcomes of smoke-free policies in prisons and jails. By implementing smoke-free policies, prisons and jails have an opportunity to improve the health of staff and inmates.
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Affiliation(s)
- Sara M Kennedy
- Biostatistics and Epidemiology, RTI International, Atlanta, GA;
| | - Shane P Davis
- Epidemiology Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Stacy L Thorne
- Epidemiology Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
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Parker DR, Roberts MB, van den Berg JJ, Bock B, Stein LAR, Martin RA, Clarke JG. Exploration of Incarcerated Men's and Women's Attitudes of Smoking in the Presence of Children and Pregnant Women: Is There a Disparity Between Smoking Attitudes and Smoking Behavior? Nicotine Tob Res 2015; 18:919-25. [PMID: 26014453 DOI: 10.1093/ntr/ntv112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 05/15/2015] [Indexed: 12/13/2022]
Abstract
INTRODUCTION A major health challenge facing persons who are incarcerated is tobacco smoking. Upon reentry to the community, concerns regarding smoking cessation may be less likely to receive needed attention. Many individuals have partners who are pregnant and/or reside in households where children and pregnant women live. We explored incarcerated adults' attitudes of smoking in the presence of children and pregnant women and how post-release smoking behaviors are influenced by their attitudes. METHODS Two hundred forty-seven incarcerated adults participated in a smoking cessation randomized clinical trial in a tobacco-free prison. An instrument was developed to examine smoking attitudes and behaviors around children and pregnant women. Moderating effects of smoking factors on post-release abstinence were examined by evaluating interactions between smoking factors and treatment group. RESULTS Four factors were defined using factor analysis: smoking around children; impact of smoking on child's health; awareness of environmental tobacco smoke (ETS) risk for pregnant women; and importance of smoking avoidance during pregnancy. We found moderation effects of smoking factors on smoking outcomes which included: treatment group by smoking behavior around children (β = 0.8085; standard error [SE] = 0.4002; P = .04); treatment group by impact of smoking on child's health (β = 1.2390; SE = 0.5632; P = .03) and for those smoking 50% fewer cigarettes post-release, treatment group by smoking impact on child's health (β = 1.2356; SE = 0.4436; P < .01). CONCLUSIONS Concern for smoking around children and pregnant women and awareness of ETS risk for pregnant women was not found to be significantly associated with smoking outcomes and requires additional investigation. Among individuals who continue to smoke post-release, effective ETS interventions are needed aimed at protecting children and pregnant women with whom they live.
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Affiliation(s)
- Donna R Parker
- Departments of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, RI; Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI;
| | - Mary B Roberts
- Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI
| | - Jacob J van den Berg
- Division of Infectious Diseases, Miriam Hospital, Providence, RI; Department of Medicine, Alpert Medical School of Brown University, Providence, RI
| | - Beth Bock
- Center for Behavioral and Preventive Medicine, Department of Psychiatry, Brown University, Providence, RI
| | - Lyn A R Stein
- Department of Psychology, University of Rhode Island, Kingston, RI
| | - Rosemarie A Martin
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Jennifer G Clarke
- Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI; Department of OB/GYN, Alpert Medical School of Brown University, Providence, RI
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Dumont DM, Parker DR, Viner-Brown S, Clarke JG. Incarceration and perinatal smoking: a missed public health opportunity. J Epidemiol Community Health 2015; 69:648-53. [DOI: 10.1136/jech-2014-204820] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 02/03/2015] [Indexed: 11/03/2022]
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Guydish J, Yu J, Le T, Pagano A, Delucchi K. Predictors of Tobacco Use Among New York State Addiction Treatment Patients. Am J Public Health 2015; 105:e57-e64. [PMID: 25393179 DOI: 10.2105/ajph.2014.302096] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. We used admissions data from the New York State addiction treatment system to assess patient self-reported tobacco use and factors associated with tobacco use. Methods. We compared prevalence of tobacco use in the state addiction treatment system with that of a national sample of people receiving addiction treatment and with that of the New York general population in 2005 to 2008. A random effects logistic model assessed relationships between patient- and program-level variables and tobacco use. Results. Prevalence of tobacco use in the New York treatment system was similar to that in national addiction treatment data and was 3 to 4 times higher than that in the general population. Co-occurring mental illness, opiate use, methadone treatment, and being a child of a substance-abusing parent were associated with higher rates of tobacco use. Conclusions. We call on federal leadership to build capacity to address tobacco use in addiction treatment, and we call on state leadership to implement tobacco-free grounds policies in addiction treatment systems.
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Affiliation(s)
- Joseph Guydish
- Joseph Guydish and Thao Le are with the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco. Jiang Yu is with the School of Social Welfare, University at Albany, State University of New York. Anna Pagano and Kevin Delucchi are with the Department of Psychiatry, University of California, San Francisco
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Abstract
Multicomponent tobacco control strategies are crucial to combat the ongoing global smoking challenge. In the twenty-first century, many countries have signed up to the World Health Organization Framework Convention on Tobacco Control, and in recent years a mounting number of countries and regions have implemented partial or complete smoking bans to protect the general public from passive smoke exposure. There is substantial evidence that workers, particularly in the hospitality sector, benefit from reduced exposure. More recently, several reports have appeared from different countries showing a temporal relationship between the introduction of a smoking ban and reduced hospital admissions for cardiovascular, respiratory and maternity outcomes. This will have a measurable benefit for public health, saving many lives. Multicomponent strategies could also reduce active smoking significantly if successfully implemented worldwide.
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30
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Affiliation(s)
- Laurel Curry
- Public Health Policy Research Program, RTI International, Washington, DC, USA
| | - Youn Ok Lee
- Public Health Policy Research Program, RTI International, Research Triangle Park, North Carolina, USA
| | - Todd Rogers
- Public Health Policy Research Program, RTI International, San Francisco, California, USA
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31
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de Tormes Eby LT, Laschober TC. Clinicians' perceptions of implementation extensiveness of 100% tobacco free practices: a longitudinal study of New York state. J Behav Health Serv Res 2014; 41:50-63. [PMID: 23430285 PMCID: PMC3683125 DOI: 10.1007/s11414-013-9319-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In 2008, the state of New York required substance use disorder treatment organizations to be 100% tobacco-free. This longitudinal study examined clinicians' perceptions of the implementation extensiveness of the tobacco-free practices approximately 10-12 months (Time 1) and 20-24 months (Time 2) post regulation and investigated whether clinicians' commitment to change and use of provided resources at Time 1 predicts perceptions of implementation extensiveness at Time 2. Clinicians (N = 287) noted a mean implementation of 5.60 patient practices (0-10 scale), 2.33 visitor practices (0-8 scale), and 6.66 employee practices (0-12 scale) at Time 1. At Time 2, clinicians perceived a mean implementation of 5.95 patient practices (no increase from Time 1), 2.89 visitor practices (increase from Time 1), and 7.12 employee practices (no increase from Time 1). Commitment to change and use of resources positively predicted perceived implementation extensiveness of visitor and employee practices. The use of resources positively predicted implementation for patient practices.
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Affiliation(s)
- Lillian Turner de Tormes Eby
- Industrial/Organizational Psychology Program, 325 Psychology Building, Athens, GA 30602, USA, Phone: 706-542-0378, Fax: 706-542-3275
- Owen’s Institute for Behavioral Research, University of Georgia, 325 Psychology Building, Athens, GA 30602, USA, Phone: 706-542-0378, Fax: 706-542-3275
| | - Tanja C. Laschober
- Owen’s Institute for Behavioral Research, University of Georgia, 325 Psychology Building, Athens, GA 30602, USA, Phone: 706-542-0378, Fax: 706-542-3275
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Richmond R, Indig D, Butler T, Wilhelm K, Archer V, Wodak A. A randomized controlled trial of a smoking cessation intervention conducted among prisoners. Addiction 2013; 108:966-74. [PMID: 23228222 PMCID: PMC3652034 DOI: 10.1111/add.12084] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Revised: 02/01/2012] [Accepted: 12/03/2012] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the efficacy of nortriptyline (NOR) added to a multi-component smoking cessation intervention, which included cognitive-behavioural therapy (CBT) and provision of nicotine replacement therapy (NRT). DESIGN Randomized controlled trial (RCT) comparing two study groups with blinded follow-up at 3, 6 and 12 months. Both groups received a multi-component smoking cessation intervention comprising two half-hour individual sessions of CBT and NRT with either active NOR or placebo. SETTING Prisons in New South Wales (17) and Queensland (one), Australia. PARTICIPANTS A total of 425 male prisoners met inclusion criteria and were allocated to either treatment (n = 206) or control group (n = 219). MEASUREMENTS Primary end-points at 3, 6 and 12 months were continuous abstinence, point prevalence abstinence and reporting a 50% reduction in smoking. Smoking status was confirmed by expired carbon monoxide, using a cut-point of ≤10 parts per million. FINDINGS Participants' demographics and baseline tobacco use were similar in treatment and control groups. Based on an intention-to-treat analysis, continuous abstinence between the treatment and control groups was not significantly different at 3 months (23.8 versus 16.4%), 6 months (17.5 versus 12.3%) and 12 months (11.7 versus 11.9%). CONCLUSION Adding nortriptyline to a smoking cessation treatment package consisting of behavioural support and nicotine replacement therapy does not appear to improve long-term abstinence rates in male prisoners.
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Affiliation(s)
- Robyn Richmond
- School of Public Health and Community Medicine, UNSWSydney, NSW, Australia
| | - Devon Indig
- School of Public Health and Community Medicine, UNSWSydney, NSW, Australia
- Centre for Health Research in Criminal Justice, Justice Health NSWEastgardens, NSW, Australia
| | - Tony Butler
- National Centre in HIV Epidemiology and Clinical Research, University of New South WalesSydney, NSW, Australia
| | - Kay Wilhelm
- Faces in the Street, Urban Mental Health Research Institute, St. Vincent's HospitalDarlinghurst, NSW, Australia
- School of Psychiatry, UNSWSydney, NSW, Australia
| | - Vicki Archer
- Centre for Health Research in Criminal Justice, Justice Health NSWEastgardens, NSW, Australia
| | - Alex Wodak
- Alcohol and Drug Service, St. Vincent's HospitalDarlinghurst, NSW, Australia
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Martin SA, Celli BR, DiFranza JR, Krinzman SJ, Clarke JG, Beam H, Howard S, Foster M, Goldberg RJ. Health effects of the Federal Bureau of Prisons tobacco ban. BMC Pulm Med 2012; 12:64. [PMID: 23067295 PMCID: PMC3556062 DOI: 10.1186/1471-2466-12-64] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 10/08/2012] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Tobacco smoking remains the leading cause of preventable death in America, claiming 450,000 lives annually. Chronic Obstructive Pulmonary Disease, caused by smoking in the vast majority of cases, became the third leading cause of death in the U.S. in 2008. The burden of asthma, often exacerbated by tobacco exposure, has widespread clinical and public health impact. Despite this considerable harm, we know relatively little about the natural history of lung disease and respiratory impairment in adults, especially after smoking cessation. METHODS/DESIGN Our paper describes the design and rationale for using the 2004 Federal Bureau of Prisons tobacco ban to obtain insights into the natural history of respiratory diseases in adult men and women of different races/ethnicities who are imprisoned in federal medical facilities. We have developed a longitudinal study of new prison arrivals, with data to be collected from each participant over the course of several years, through the use of standardized questionnaires, medical chart reviews, lung function tests, six-minute walk tests, and stored serum for the analysis of present and future biomarkers. Our endpoints include illness exacerbations, medication and health services utilization, lung function, serum biomarkers, and participants' experience with their health and nicotine addiction. DISCUSSION We believe the proposed longitudinal study will make a substantial contribution to the understanding and treatment of respiratory disease and tobacco addiction.
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Affiliation(s)
- Stephen A Martin
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Barre Family Health Center, 151 Worcester Road, Barre, MA, 01005, USA
| | - Bartolome R Celli
- Harvard Medical School, Brigham and Women’s Hospital, Pulmonary and Critical Care Medicine, 75 Francis Street, Boston, MA, 02115, USA
| | - Joseph R DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Stephen J Krinzman
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Jennifer G Clarke
- The Warren Alpert Medical School of Brown University, 111 Brewster Street, CPCP 2nd floor, Pawtucket, RI, 02860, USA
| | - Herbert Beam
- Federal Bureau of Prisons, Federal Medical Center, Devens, P.O. Box 880, Ayer, MA, 01432, USA
| | - Sandra Howard
- Federal Bureau of Prisons, Federal Medical Center, Devens, P.O. Box 880, Ayer, MA, 01432, USA
| | - Melissa Foster
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Robert J Goldberg
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
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Makris E, Gourgoulianis KI, Hatzoglou C. Prisoners and cigarettes or 'imprisoned in cigarettes'? What helps prisoners quit smoking? BMC Public Health 2012; 12:508. [PMID: 22768845 PMCID: PMC3433336 DOI: 10.1186/1471-2458-12-508] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 07/07/2012] [Indexed: 11/10/2022] Open
Abstract
Abstract Background The aim of the study was, despite the special characteristics of prisons, to identify the features which led prisoners who attended the Smoking Cessation Centre at the Kassavetia Detention Centre in Volos (region of Thessaly, in the central part of mainland Greece) to quit smoking. Methods Personal interviews with 204 male prisoners irrespective of smoking habitus over the period June 2008 to December 2010 were obtained. Information about medical history, history of tobacco use and addiction to narcotic use was obtained and imprisonment status was recorded. Pharmaceutical treatment (Varenicline) and counselling or only counselling were suggested as alternative strategies to them in order to help quit smoking. SPSS v15.0 software was employed, descriptive statistics were used, and a X2 independence test and Student’s t-test were performed. Results Of the sample examined, 75.5% (154) were smokers. They were mainly Greeks (51.5%), single (53.4%) and had not gratuated from a high school (secondary education level) (70.6%). 59.75% begun smoking early ( ≤14 years of age ) and 64.9% were highly addicted according to Fagerstrom Tolerance Questionnaire. 74% (114) of all smokers at the prison attended the Smoking Cessation Centre. Of them, 30.7% were able to quit smoking at 3 months but 1 year later there were 20.2% ex-smokers. The key characteristics of those who were able to be ex-smokers were a change in smoking habits (decreased) compared to when free (p = .001), previous attempts to quit (while incarcerated and in general) (p = .001), average dependence levels (p < .001), started smoking after 21 years of age (p = .032), no history of addictive substance use (p = .029), being already prisoners for a longer period of time (p = .019), a limited number (3.9 ± 3.4) of prisoners per cell (p < .001) and in particular a limited number (2.8 ± 3.2) of smokers in the cell (p < .001). Conclusions Average dependence, a past free of addictive substance abuse and a better environment of daily living for certain prisoners (as far as the number of cellmates was concerned) had a catalytic impact on prisoners finally managed to quit smoking.
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Affiliation(s)
- Elias Makris
- Respiratory Department, University of Thessaly, Larissa 41110, Greece.
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