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Mambro A, Afshar A, Leone F, Dussault C, Stoové M, Savulescu J, Rich JD, Rowan DH, Sheehan J, Kronfli N. Reimbursing incarcerated individuals for participation in research: A scoping review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 123:104283. [PMID: 38109837 DOI: 10.1016/j.drugpo.2023.104283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/18/2023] [Accepted: 11/29/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Little is known about global practices regarding the provision of reimbursement for the participation of people who are incarcerated in research. To determine current practices related to the reimbursement of incarcerated populations for research, we aimed to describe international variations in practice across countries and carceral environments to help inform the development of more consistent and equitable practices. METHODS We conducted a scoping review by searching PubMed, Cochrane library, Medline, and Embase, and conducted a grey literature search for English- and French-language articles published until September 30, 2022. All studies evaluating any carceral-based research were included if recruitment of incarcerated participants occurred inside any non-juvenile carceral setting; we excluded studies if recruitment occurred exclusively following release. Where studies failed to indicate the presence or absence of reimbursement, we assumed none was provided. RESULTS A total of 4,328 unique articles were identified, 2,765 were eligible for full text review, and 426 were included. Of these, 295 (69%) did not offer reimbursement to incarcerated individuals. A minority (n = 13; 4%) included reasons explaining the absence of reimbursement, primarily government-level policies (n = 7). Among the 131 (31%) studies that provided reimbursement, the most common form was monetary compensation (n = 122; 93%); five studies (4%) offered possible reduced sentencing. Reimbursement ranged between $3-610 USD in total and 14 studies (11%) explained the reason behind the reimbursements, primarily researchers' discretion (n = 9). CONCLUSIONS The majority of research conducted to date in carceral settings globally has not reimbursed incarcerated participants. Increased transparency regarding reimbursement (or lack thereof) is needed as part of all carceral research and advocacy efforts are required to change policies prohibiting reimbursement of incarcerated individuals. Future work is needed to co-create international standards for the equitable reimbursement of incarcerated populations in research, incorporating the voices of people with lived and living experience of incarceration.
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Affiliation(s)
- Andrea Mambro
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Avideh Afshar
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Frederic Leone
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Camille Dussault
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Mark Stoové
- Burnet Institute, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, United Kingdom; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Josiah D Rich
- Center for Health and Justice Transformation, The Miriam and Rhode Island Hospitals, Departments of Medicine and Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Daniel H Rowan
- Division of Infectious Disease, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | | | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, Division of Infectious Disease and Chronic Viral Illness Service, McGill University, Montreal, Quebec, Canada.
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Saloner B, Li W, Flores M, Progovac AM, Lê Cook B. A Widening Divide: Cigarette Smoking Trends Among People With Substance Use Disorder And Criminal Legal Involvement. Health Aff (Millwood) 2023; 42:187-196. [PMID: 36745833 PMCID: PMC10157835 DOI: 10.1377/hlthaff.2022.00901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
People with substance use disorder (SUD) smoke cigarettes at a rate more than twice that of the general population. Policies and programs have focused on promoting smoking cessation among people with SUD, yet it is unclear whether interventions have adequately reached the subgroup involved in the criminal legal system, who have among the highest smoking rates. Drawing on repeated cross-sections of the National Survey on Drug Use and Health, we found that smoking rates declined by 9.4 percentage points overall among people with SUD from 2010 to 2019, but rates remained virtually unchanged among the subgroup with criminal legal involvement. In regression analyses focused on people with SUD, three-quarters of the excess smoking burden for those with criminal legal involvement at baseline (2010-13) was accounted for by controlling for sociodemographics, substance use type, health insurance, and recent SUD treatment. However, even after we controlled for these same factors, the disparity in smoking prevalence among people with SUD between those with and without criminal legal involvement remained constant over time. These findings underscore the need for smoking cessation interventions focused on the criminal legal system, including correctional facilities and SUD treatment programs that serve people in this population.
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Affiliation(s)
- Brendan Saloner
- Brendan Saloner , Johns Hopkins University, Baltimore, Maryland
| | - Wenshu Li
- Wenshu Li, Foundation Medicine, Cambridge, Massachusetts
| | - Michael Flores
- Michael Flores, Cambridge Health Alliance and Harvard University, Cambridge, Massachusetts
| | - Ana M Progovac
- Ana M. Progovac, Cambridge Health Alliance and Harvard University
| | - Benjamin Lê Cook
- Benjamin Lê Cook, Cambridge Health Alliance and Harvard University
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3
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Ives K, Christiansen B, Nolan M, Kaye JT, Fiore MC. Nine years of smoking data from incarcerated men: A call to action for tobacco dependence interventions. Prev Med Rep 2022; 29:101921. [PMID: 35911575 PMCID: PMC9326308 DOI: 10.1016/j.pmedr.2022.101921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
Nearly all people in prison return to smoking shortly after release. Smoking prevalence prior to prison remains very high and is not changing. Most prison survey respondents do not consider themselves addicted. Prison survey respondents have become less interested in help to stay tobacco free. Survey results suggest possible elements for tobacco interventions.
People who are incarcerated use tobacco in high numbers before incarceration and the vast majority resume tobacco use soon after release despite institutional smoking bans. Nine years of surveys collected at a correctional facility in the Midwest, U.S., were analyzed to identify the needs of this high-risk population and suggest future directions for research and intervention development. For the most part, survey respondents considered themselves no longer addicted to tobacco and intended to remain tobacco free after release. They increasingly expected support to remain tobacco free from their home environment despite no change in home tobacco use. Over this nine-year period, significantly fewer respondents wanted materials and help to remain tobacco free, suggesting they have become more challenging to assist. Implications for intervention development and future research are discussed.
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Affiliation(s)
- Kari Ives
- Wisconsin Department of Corrections, 3099 East Washington Ave, Madison, WI 53704, USA
| | - Bruce Christiansen
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St Suite 200, Madison, WI 53711, USA
| | - Margaret Nolan
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St Suite 200, Madison, WI 53711, USA
| | - Jesse T Kaye
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St Suite 200, Madison, WI 53711, USA
| | - Michael C Fiore
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St Suite 200, Madison, WI 53711, USA
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Circumstances Around Cigarette Use After Enforced Abstinence From Smoking in an American Prison. J Addict Med 2022; 16:e405-e411. [PMID: 35916410 PMCID: PMC9675643 DOI: 10.1097/adm.0000000000001005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Most adults return to smoking after enforced tobacco abstinence when incarcerated in US prisons. Little is known about the specific relapse triggers on reentry. This study examines situational, affective, and motivational antecedents of return to smoking immediately after release from a tobacco-free prison. METHODS Assessments were administered before release and 1 and 7 days after release to 190 incarcerated adults who were smokers before incarceration. Those reporting smoking within 7 days after release were asked about circumstances surrounding their first cigarette. RESULTS Two-thirds reported smoking in the 7 days after release (76% of those in the first day) with the first cigarette smoked 21 hours after release on average. Smoking occurred more quickly for women than men and for those who planned to smoke after release (P values from 0.05 to 0.001). Forty-one percent of participants smoked while waiting for a ride or on the way home, 68% were given their first cigarette, 28% reported first smoking when reuniting with others, 42% first smoked with smokers, and 26% first smoked as celebration. The moods most reported before smoking were happy (60%) or excited (41.5%). Factors reported that could have prevented smoking were avoiding other smokers (27%), avoiding stress (16%), not drinking/using drugs (12%), and not having access to cigarettes (11%). CONCLUSIONS High rates of return to smoking occurred rapidly when around other smokers, using other substances, and in a positive mood. Interventions that focus specifically on these factors and can be immediately accessed upon release are required to help sustain people's desired abstinence.
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Perrett SE, Craddock C, Dunseath G, Shankar G, Luzio S, Gray BJ. Evaluating the impact of a prison smoking ban on the cardiovascular health of men in a UK prison. Int J Prison Health 2022; 19:340-349. [PMID: 35687323 DOI: 10.1108/ijph-02-2022-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Smoking rates are known to be higher amongst those committed to prison than the general population. Those in prison suffer from high rates of comorbidities that are likely to increase their risk of cardiovascular disease (CVD), making it more difficult to manage. In 2016, a tobacco ban began to be implemented across prisons in England and Wales, UK. This study aims to measure the effect of the tobacco ban on predicted cardiovascular risk for those quitting smoking on admission to prison. DESIGN/METHODOLOGY/APPROACH Using data from a prevalence study of CVD in prisons, the authors have assessed the effect of the tobacco ban on cardiovascular risk, using predicted age to CVD event, ten-year CVD risk and heart age, for those who previously smoked and gave up on admission to prison. FINDINGS The results demonstrate measurable health gains across all age groups with the greatest gains found in those aged 50 years and older and who had been heavy smokers. Quitting smoking on admission to prison led to a reduced heart age of between two and seven years for all participants. ORIGINALITY/VALUE The data supports tobacco bans in prisons as a public health measure to reduce risk of CVD. Interventions are needed to encourage maintenance of smoking cessation on release from prison for the full health benefits to be realised.
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Affiliation(s)
| | | | - Gareth Dunseath
- Diabetes Research Group Swansea, Swansea University, Swansea, UK
| | - Giri Shankar
- Department of Health Protection, Public Health Wales, Cardiff, UK
| | - Stephen Luzio
- Diabetes Research Group Swansea, Swansea University, Swansea, UK
| | - Benjamin J Gray
- Research and Evaluation Division, Public Health Wales, Cardiff, UK
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Hechanova MRM, Reyes JC, Acosta AC, Tuliao AP. Psychosocial treatment for incarcerated methamphetamine users: the Philippines experience. Int J Prison Health 2020; 16:343-358. [PMID: 33634665 DOI: 10.1108/ijph-09-2019-0044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study is to evaluate a psychosocial treatment program for prisoners incarcerated because of methamphetamine use. It compared the outcomes of prisoners who received the program while incarcerated, those who were released and received the treatment as part of community-based drug recovery program and a waitlist-control group (WC) with no treatment. DESIGN/METHODOLOGY/APPROACH A quasi-experimental design was use with pre- and post-test surveys administered to three groups: a WC group, a pre-release treatment-while-incarcerated (TWI) group, and a post-release outpatient treatment group (OP). Surveys measured recovery skills, life skills and substance use disorder (SUD) symptoms were administered before and after the intervention. FINDINGS Results revealed that at baseline OP and TWI had significant higher recovery skills compared to WC group. However, in terms of life skills, there was no significant difference observed among the WC, OP and TWI group at baseline. TWI had a significantly lower number of SUD symptoms compared to the WC group at baseline. As hypothesized, findings revealed significant changes in recovery and life skills among the OP and TWI group compared to the WC group. No significant change in SUD scores were observed for all groups. RESEARCH LIMITATIONS/IMPLICATIONS A major limitation of the study was the use of a quasi-experimental design because legal issues did not allow a randomized control trial. Future research using randomized controlled trial designs would provide more robust conclusions on the impact of the intervention. The study design was also limited to pre- and post-evaluation. Further studies are encouraged to look at longitudinal outcomes of appears on SUD symptoms and possibility of relapse. PRACTICAL IMPLICATIONS Given that there were no significant differences in outcomes between OP and TWI groups, results suggest that the program may serve either as a pre- or post-release program for incarcerated drug users. However, results also suggest that completion is higher when the program is used as a pre-release program. Delivering the program prior to release also reduces challenges related to attrition including conflict in schedules and the lack of resources for transportation. SOCIAL IMPLICATIONS The study suggests the value of psychosocial treatment as opposed to punitive approaches in dealing with drug use. In particular, delivering interventions prior to release can prepare participants for problems they may encounter during reintegration and prevent recidivism. In a country where drug-related killings are on the rise, the study presents an alternate and restorative justice approach. ORIGINALITY/VALUE The study addresses a dearth in the literature on psychosocial intervention for methamphetamine users. It also fills a vacuum in studies from developing countries such as the Philippines.
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Affiliation(s)
- Ma Regina M Hechanova
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines, and University Research Co., LLC, Bethesda, Maryland, USA
| | - Jennel C Reyes
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | - Avegale C Acosta
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | - Antover P Tuliao
- Department of Community Family and Addiction Sciences, Texas Tech University, Lubbock, Texas, USA
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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: 21] [Impact Index Per Article: 5.3] [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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Spaulding AC, Eldridge GD, Chico CE, Morisseau N, Drobeniuc A, Fils-Aime R, Day C, Hopkins R, Jin X, Chen J, Dolan KA. Smoking in Correctional Settings Worldwide: Prevalence, Bans, and Interventions. Epidemiol Rev 2018; 40:82-95. [PMID: 29746635 PMCID: PMC5982806 DOI: 10.1093/epirev/mxy005] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 02/27/2018] [Indexed: 12/12/2022] Open
Abstract
Smoking tobacco contributes to 11.5% of deaths worldwide and, in some countries, more hospitalizations than alcohol and drugs combined. Globally in 2015, 25% of men and 5% of women smoked. In the United States, a higher proportion of people in prison smoke than do community-dwelling individuals. To determine smoking prevalence in prisons worldwide, we systematically reviewed the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines; we also examined whether prisons banned smoking or treated smokers. We searched databases for articles published between 2012 and 2016 and located 85 relevant articles with data representing 73.5% of all incarcerated persons from 50 countries. In 35 of 36 nations (97%) with published prevalence data, smoking for the incarcerated exceeded community rates 1.04- to 62.6-fold. Taking a conservative estimate of a 2-fold increase, we estimated that, globally, 14.5 million male and 26,000 female smokers pass through prisons annually. Prison authorities’ responses include permitting, prohibiting, or treating tobacco use. Bans may temporarily improve health and reduce in-prison health care costs but have negligible effect after prison release. Evidence-based interventions for smoking cessation effective outside prisons are effective inside; effects persist after release. Because smoking prevalence is heightened in prisons, offering evidence-based interventions to nearly 15 million smokers passing through yearly would improve global health.
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Affiliation(s)
- Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Cynthia E Chico
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Nancy Morisseau
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ana Drobeniuc
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Rebecca Fils-Aime
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Carolyn Day
- Discipline of Addiction Medicine, Central Clinical School, University of Sydney, New South Wales, Australia
| | - Robyn Hopkins
- Department of the Attorney-General and Justice, Northern Territory Correctional Services, Darwin, Australia
| | - Xingzhong Jin
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Junyu Chen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kate A Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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van den Berg JJ, Adeyemo S, Roberts MB, Bock BC, Stein LAR, Martin RA, Parker DR, Clarke JG. Comparing the Validity of Self-Report and Urinalysis for Substance Use among Former Inmates in the Northeastern United States. Subst Use Misuse 2018; 53:1756-1761. [PMID: 29419341 DOI: 10.1080/10826084.2018.1432646] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Problems with self-reported drug use include difficulties with recall and recognition as well as the desire to respond to questions in a socially desirable manner. Various methods have been developed to improve and/or validate estimates based on direct questioning of individuals regarding their substance use. For this study, we were interested in validating self-reported use of: 1) tobacco, 2) marijuana, and 3) other substances (i.e., heroin, cocaine, opiates, oxycodone, benzodiazepines, methamphetamine, phencyclidine, and barbiturates) employing urinalysis among inmates who participated in a randomized controlled trial of a smoking abstinence intervention in a tobacco-free prison located in the northeastern United States. METHODS Two-hundred and seven men and women with a mean age of 34.9 (standard deviation = 9.0) completed questions regarding their substance use on a 7-day Timeline Follow-Back and provided urine specimens three weeks following prison release. RESULTS Self-reported tobacco and marijuana use were highly consistent with urine drug testing in terms of overall agreement and Kappa (93.7% and.804 for tobacco, respectively; and 90.3% and.804 for marijuana, respectively); however, consistency was much lower for other drug use grouped together (62.7% and.270). DISCUSSION Although some former inmates may not accurately report substance use, our findings indicate that they are in the minority, suggesting that self-report is valid for tobacco and marijuana use but much less so for other drugs grouped together. Future research should be conducted with a larger and more diverse sample of former inmates to establish the generalizability of our findings from this study.
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Affiliation(s)
- Jacob J van den Berg
- a Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , Rhode Island , USA
| | - Samuel Adeyemo
- b Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island , Pawtucket , Rhode Island , USA
| | - Mary B Roberts
- b Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island , Pawtucket , Rhode Island , USA
| | - Beth C Bock
- c Department of Psychiatry and Human Behavior , Alpert Medical School of Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital , Providence , Rhode Island , USA
| | - L A R Stein
- a Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , Rhode Island , USA.,d Department of Psychology , University of Rhode Island , Kingston , Rhode Island , USA.,f Rhode Island Training School , Cranston , Rhode Island , USA
| | - Rosemarie A Martin
- a Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , Rhode Island , USA
| | - Donna R Parker
- e Departments of Family Medicine and Epidemiology , Brown University School of Public Health , Providence , Rhode Island , USA
| | - Jennifer G Clarke
- b Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island , Pawtucket , Rhode Island , USA.,g Departments of Medicine and Obstetrics and Gynecology , Alpert Medical School of Brown University , Providence , Rhode Island , USA
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Brose LS, Simonavicius E, McNeill A. Maintaining abstinence from smoking after a period of enforced abstinence - systematic review, meta-analysis and analysis of behaviour change techniques with a focus on mental health. Psychol Med 2018; 48:669-678. [PMID: 28780913 PMCID: PMC5681216 DOI: 10.1017/s0033291717002021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Smoking prevalence is doubled among people with mental health problems and reaches 80% in inpatient, substance misuse and prison settings, widening inequalities in morbidity and mortality. As more institutions become smoke-free but most smokers relapse immediately post-discharge, we aimed to review interventions to maintain abstinence post-discharge. METHODS MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science were searched from inception to May 2016 and randomised controlled trials (RCTs) and cohort studies conducted with adult smokers in prison, inpatient mental health or substance use treatment included. Risk of bias (study quality) was rated using the Effective Public Health Practice Project Tool. Behaviour change techniques (BCTs) were coded from published papers and manuals using a published taxonomy. Mantel-Haenszel random effects meta-analyses of RCTs used biochemically verified point-prevalence smoking abstinence at (a) longest and (b) 6-month follow-up. RESULTS Five RCTs (n = 416 intervention, n = 415 control) and five cohort studies (n = 471) included. Regarding study quality, four RCTs were rated strong, one moderate; one cohort study was rated strong, one moderate and three weak. Most common BCTs were pharmacotherapy (n = 8 nicotine replacement therapy, n = 1 clonidine), problem solving, social support, and elicitation of pros and cons (each n = 6); papers reported fewer techniques than manuals. Meta-analyses found effects in favour of intervention [(a) risk ratio (RR) = 2.06, 95% confidence interval (CI) 1.30-3.27; (b) RR = 1.86, 95% CI 1.04-3.31]. CONCLUSION Medication and/or behavioural support can help maintain smoking abstinence beyond discharge from smoke-free institutions with high mental health comorbidity. However, the small evidence base tested few different interventions and reporting of behavioural interventions is often imprecise.
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Affiliation(s)
- L S Brose
- Department of Addictions,Institute of Psychiatry, Psychology and Neuroscience,King's College London,London,UK
| | - E Simonavicius
- Department of Addictions,Institute of Psychiatry, Psychology and Neuroscience,King's College London,London,UK
| | - A McNeill
- Department of Addictions,Institute of Psychiatry, Psychology and Neuroscience,King's College London,London,UK
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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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12
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Hopkins R, Dolan KA. Trends in cancer incidence and survival for Indigenous and non-Indigenous people in the Northern Territory. Med J Aust 2017; 207:46. [PMID: 28659120 DOI: 10.5694/mja16.01390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 01/03/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Robyn Hopkins
- Northern Territory Department of Correctional Services, Darwin, NT
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13
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Garver-Apgar C, Young S, Howard B, Udochi B, Morris C. Effects of a Statewide Tobacco Cessation Program Among Individuals Involved With Arkansas Community Correction. JOURNAL OF CORRECTIONAL HEALTH CARE 2017; 23:259-270. [PMID: 28534434 DOI: 10.1177/1078345817709017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In response to a critical need for tobacco cessation services among justice-involved populations, Arkansas Community Correction (ACC) partnered with the University of Colorado's Behavioral Health & Wellness Program in 2013 to implement the DIMENSIONS: Tobacco Free Program within all probation, parole, and drug court units. In the first 2 years of this statewide, evidence-based program, more than 1,100 individuals from 33 ACC area office locations attended tobacco-free group sessions and provided data on tobacco use and readiness to quit. Results demonstrated a significant reduction in tobacco use among participants as well as increased knowledge, confidence, and intent to quit. This study provides some of the first evidence that members of this vulnerable population will attend tobacco-free group sessions with regularity and make progress toward tobacco cessation.
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Affiliation(s)
| | - Susan Young
- 1 Behavioral Health & Wellness Program, University of Colorado, Aurora, CO, USA
| | - Brenda Howard
- 2 Department of Human Services, Division of Children and Family Services, Conway, AR, USA
| | - Ben Udochi
- 3 Arkansas Community Correction, Probation & Parole Treatment Services, Little Rock, AR, USA
| | - Chad Morris
- 1 Behavioral Health & Wellness Program, University of Colorado, Aurora, CO, USA
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van den Berg JJ, Bock BC, Roberts MB, Parker DR, Martin RA, Stein LAR, Clarke JG. Goals and Plans of Incarcerated Men Postrelease. JOURNAL OF CORRECTIONAL HEALTH CARE 2017; 22:146-56. [PMID: 26984138 DOI: 10.1177/1078345816635187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prior research has not examined the self-identified goals and plans of incarcerated people as they approach release from prison. This study analyzed the goals and plans generated during a motivational interviewing counseling session of incarcerated men who participated in a randomized controlled trial of a smoking abstinence intervention in a tobacco-free prison in the northeastern United States. Using thematic analysis, 53 written goals and plans were independently coded by trained research assistants to identify major themes that included (1) staying smoke-free or reducing the number of cigarettes smoked postrelease, (2) engaging in physical activities to improve health and wellness, and (3) spending time with family and/or friends. Implications for working with inmates to identify their plans and goals to remain smoke-free after incarceration are discussed.
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Affiliation(s)
- Jacob J van den Berg
- Division of Infectious Diseases, Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA
| | - Beth C Bock
- Alpert Medical School of Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Mary B Roberts
- Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI, USA
| | - Donna R Parker
- Departments of Family Medicine and Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Rosemarie A Martin
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - L A R Stein
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Jennifer G Clarke
- Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI, USA
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Clarke JG, Martin SA, Martin RA, Stein LAR, van den Berg JJ, Parker DR, McGovern AR, Roberts MB, Bock BC. Changes in smoking-related symptoms during enforced abstinence of incarceration. J Health Care Poor Underserved 2016; 26:106-18. [PMID: 25702731 DOI: 10.1353/hpu.2015.0014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Tobacco use among prisoners is much higher than among the general population. Little is known about changes in smoking-related symptoms during periods of incarceration. The objective of this study is to evaluate changes in smoking-related symptoms during incarceration. METHODS We recruited 262 inmates from a tobacco-free prison. At baseline, participants were asked about smoking-related symptoms prior to incarceration and then asked about recent symptoms. RESULTS All symptom scores on the American Thoracic Society Questionnaire (ATSQ) improved during incarceration. Higher ATSQ scores were associated with asthma, depressive symptoms, stress, higher addiction and more pack years of smoking. Greater improvement in symptoms was not associated with smoking status after release. CONCLUSION Forced tobacco abstinence leads to significant improvements in smoking-related symptoms. However, improvements in symptoms are not associated with smoking behavior changes. Addressing changes in symptoms during incarceration will require further evaluation in smoking cessation interventions for incarcerated populations.
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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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Changes in Depression and Stress after Release from a Tobacco-Free Prison in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13010114. [PMID: 26771622 PMCID: PMC4730505 DOI: 10.3390/ijerph13010114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/04/2016] [Accepted: 01/06/2016] [Indexed: 11/30/2022]
Abstract
Prior research has found high levels of depression and stress among persons who are incarcerated in the United States (U.S.). However, little is known about changes in depression and stress levels among inmates post-incarceration. The aim of this study was to examine changes in levels of depression and stress during and after incarceration in a tobacco-free facility. Questionnaires that included valid and reliable measures of depression and stress were completed by 208 male and female inmates approximately eight weeks before and three weeks after release from a northeastern U.S. prison. Although most inmates improved after prison, 30.8% had a worsening in levels of depression between baseline and the three-week follow-up. In addition, 29.8% had a worsening in levels of stress after release than during incarceration. While it is not surprising that the majority of inmates reported lower levels of depression and stress post-incarceration, a sizable minority had an increase in symptoms, suggesting that environmental stressors may be worse in the community than in prison for some inmates. Further research is needed to address depression and stress levels during and after incarceration in order for inmates to have a healthier transition back into the community and to prevent repeat incarcerations.
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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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Moschetti K, Stadelmann P, Wangmo T, Holly A, Bodenmann P, Wasserfallen JB, Elger BS, Gravier B. Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions. BMC Public Health 2015; 15:872. [PMID: 26358116 PMCID: PMC4566300 DOI: 10.1186/s12889-015-2211-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/02/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Literature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age. METHODS This study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women. RESULTS A total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women. CONCLUSION It is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions.
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Affiliation(s)
- Karine Moschetti
- Institut universitaire de médecine sociale et préventive, Unité d'evaluation des soins, University Hospital of Lausanne (CHUV), Route de la Corniche 10, 1010, Lausanne, Switzerland.
- Technology Assessment Unit (UET), University Hospital of Lausanne (CHUV), Lausanne, 1011, Switzerland.
- IEMS - Plateforme interfacultaire en économie et management de la santé, University of Lausanne CH, Internef Building, Lausanne, 1015, Switzerland.
| | - Pierre Stadelmann
- Institut universitaire de médecine sociale et préventive, Unité d'evaluation des soins, University Hospital of Lausanne (CHUV), Route de la Corniche 10, 1010, Lausanne, Switzerland.
- IEMS - Plateforme interfacultaire en économie et management de la santé, University of Lausanne CH, Internef Building, Lausanne, 1015, Switzerland.
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, Basel, 4056, Switzerland.
| | - Alberto Holly
- Institut d'économie et management de la santé (IEMS), HEC Lausanne and Département d'économétrie et d'économie politique (DEEP), University of Lausanne, Internef Building, Lausanne, 1015, Switzerland.
| | - Patrick Bodenmann
- Vulnerable Population Center, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, 1011, Switzerland.
| | - Jean-Blaise Wasserfallen
- Technology Assessment Unit (UET), University Hospital of Lausanne (CHUV), Lausanne, 1011, Switzerland.
| | - Bernice S Elger
- Institute for Biomedical Ethics, Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, Basel, 4056, Switzerland.
- Centre universitaire romand de médecine légale, University of Geneva, Geneva, Switzerland.
| | - Bruno Gravier
- Service of Correctional Medicine and Psychiatry (SMPP), University Hospital of Lausanne (CHUV), Prilly-Lausanne, 1008, Switzerland.
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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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The association between impulsivity and alcohol/drug use among prison inmates. Addict Behav 2015; 42:140-3. [PMID: 25462662 DOI: 10.1016/j.addbeh.2014.11.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/22/2014] [Accepted: 11/18/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Few studies have examined the relation between impulsivity and drug involvement with prison inmates, in spite of their heavy drug use. Among this small body of work, most studies look at clinically relevant drug dependence, rather than drug use specifically. METHOD N=242 adult inmates (34.8% female, 52% White) with an average age of 35.58 (SD=9.19) completed a modified version of the 15-item Barratt Impulsiveness Scale (BIS) and measures assessing lifetime alcohol, opiate, benzodiazepine, cocaine, cannabis, hallucinogen, and polysubstance use. Lifetime users also reported the frequency of use for the 30days prior to incarceration. RESULTS Impulsivity was higher among lifetime users (versus never users) of all substances other than cannabis. Thirty day drug use frequency was only related to impulsivity for opiates and alcohol. DISCUSSION This study extends prior work, by showing that a lifetime history of non-clinical substance use is positively associated with impulsivity among prison inmates. Implications for drug interventions are considered for this population, which is characterized by high rates of substance use and elevated impulsivity.
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Valera P, Anderson M, Cook SH, Wylie-Rosett J, Rucker J, Reid AE. The smoking behaviors and cancer-related disparities among urban middle aged and older men involved in the criminal justice system. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:86-93. [PMID: 24832966 PMCID: PMC4234703 DOI: 10.1007/s13187-014-0668-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examined cancer knowledge, mental health, and tobacco use in formerly incarcerated men. The Cancer-Health Research Study with Formerly Incarcerated Men in New York City used a cross-sectional research design to examine cancer knowledge and prevention (CKP) outcomes among 259 justice-involved males, ages 35-67. CKP was assessed using items from the National Cancer Institute's Health Information National Trends Survey. Psychological symptoms were examined using the Brief Symptom Inventory. Of the 259 men who completed the survey, 76% of the respondents self-reported as current smokers. Current smokers smoked between 1 and 40 cigarettes per day. The mean number of cigarettes smoked per day was 10.37 (SD = 6.76). Sixty-five percent (n = 165) of the respondents underwent cancer-screening tests. CKP scores ranged from 2 to 28; the mean was 15.05 (SD = 5.49), indicating that the men scored very low in terms of CKP. CKP scores were negatively associated with the number of cigarettes smoked per day, τ = -.13, p = .01. These results have important implications for enhancing access to cancer-health education programs in justice-involved settings.
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Affiliation(s)
- Pamela Valera
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722W. 168th Street, Room 940, New York, NY, 10032, USA,
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Lantini R, van den Berg JJ, Roberts MB, Bock BC, Stein LAR, Parker DR, Friedmann PD, Clarke JG. Characteristics of smoking used cigarettes among an incarcerated population. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2014; 29:254-8. [PMID: 25180554 DOI: 10.1037/adb0000019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Little is known about smoking behaviors involving shared and previously used cigarettes, which we refer to as "smoking used cigarettes." Examples include: cigarette sharing with strangers, smoking discarded cigarettes ("butts"), or remaking cigarettes from portions of discarded cigarettes. The current study focuses on the prevalence of and factors associated with smoking used cigarettes prior to incarceration among a U.S. prison population. Questionnaires were administered to 244 male and female inmates at baseline. Prevalence of smoking used cigarettes was assessed using 3 questions; 1 about sharing cigarettes with strangers, 1 about smoking a "found" cigarette, and 1 about smoking previously used cigarettes. Factors associated with those who engaged in smoking used cigarettes were then compared with those who did not engage in smoking used cigarettes. A majority of participants (61.5%) endorsed engaging in at least 1 smoking used cigarette behavior in the past prior to incarceration. Those who engaged in these behaviors were more likely to have a higher degree of nicotine dependence, to have started smoking regularly at a younger age, and to have lived in an unstable living environment prior to incarceration. Our results indicate that a history of smoking used cigarettes is common among incarcerated persons in the United States. Consistent with our hypothesis, engaging in smoking used cigarettes was found to be associated with a higher degree of nicotine dependence. (PsycINFO Database Record
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Affiliation(s)
- Ryan Lantini
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital
| | | | | | - Beth C Bock
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital
| | - L A R Stein
- Social Sciences Research Center, Department of Psychology, University of Rhode Island
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Parker DR, Fallone D, Martin RA, Stein LAR, Bock B, Martin SA, Roberts MB, Lopes CE, Clarke JJ. The relation between smoking status and medical conditions among incarcerated adults. J Addict Med 2014; 8:90-5. [PMID: 24503925 PMCID: PMC4077401 DOI: 10.1097/adm.0b013e3182a96466] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The rate of smoking among incarcerated adults is more than 3 times that of the general population. Negative health consequences of smoking have prompted many correctional facilities to become tobacco-free. This presents a unique opportunity to examine health conditions associated with motivation to remain tobacco-free after release from prison. We examined this association among individuals who participated in the WISE randomized clinical trial. METHODS A total of 247 participants completed a baseline questionnaire asking about illnesses (both smoking-related and non-smoking-related), family history of smoking-related illnesses, demographics, and smoking history. Smoking status was assessed 3 weeks postrelease. RESULTS Approximately 38% of participants reported having an illness caused by or worsened by smoking and 53.0% reported having "moderate" to "a lot" of concern about their health due to smoking; 22.9% reported having asthma and 26.8% reported hypertension. The adjusted odds of remaining tobacco-free at 3 weeks postrelease from a tobacco-free prison was significant only for individuals with a family history of smoking-related illnesses (odds ratio [OR] = 0.28; 95% confidence interval [CI], 0.12-0.68). For individuals with smoking-related conditions, the adjusted odds of remaining tobacco-free was nonsignificant (OR = 1.91; 95% CI, 0.85-4.27). Similarly, the adjusted odds of remaining tobacco-free for participants with non-smoking-related medical conditions was nonsignificant (OR = 0.27; 95% CI, 0.06-1.22). CONCLUSIONS These results offer a first look at understanding health conditions as a motivator to remain tobacco-free after release from prison. Although these findings require additional investigation, these results suggest that providing treatment to prisoners with chronic disease and specifically targeting smoking-related illnesses might be beneficial with regard to smoking cessation success.
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Affiliation(s)
- Donna R Parker
- From the Departments of Family Medicine and Epidemiology (DRP), Alpert Medical School of Brown, University, Providence, RI; Brown University Center for Primary Care and Prevention (DRP, MBR, JJC), Memorial Hospital of Rhode Island, Pawtucket; Memorial Hospital of Rhode Island (DF), Pawtucket; Department of Medicine (RAM, JJC), Alpert Medical School of Brown University, Providence, RI; Psychology Department & Social Sciences Research Center (LARS), University of RI, Kingston; RI Training School (LARS), Cranston; Center for Behavioral and Preventive Medicine (BB), Department of Psychiatry, Brown University, Providence, RI; Department of Family Medicine and Community Health (SAM), University of Massachusetts, Medical School, Worcester; Rhode Island Department of Corrections (CEL), Cranston; and Department of OB/GYN (JJC), Alpert Medical School of Brown University, Providence, RI
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Valera P, Cook SH, Darout R, Dumont DM. "They are not taking cigarettes from me . . . I'm going to smoke my cigarettes until the day I die. I don't care if I get cancer": smoking behaviors of men under community supervision in New York City. Nicotine Tob Res 2014; 16:800-6. [PMID: 24480803 DOI: 10.1093/ntr/ntt280] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Cigarette smoking declined from 42.4% in 1965 to 19.3% in 2010 among the general population, but it remains the leading cause of preventable death and illness in the United States, especially among high-risk populations, including those with criminal justice involvement. METHODS A mixed-methods approach was used to investigate the smoking behaviors of men under parole or probation. Phase I focused on qualitative data of 30 semi-structured interviews of men who were recently released from a state prison and/or jail. Phase II analyzed quantitative data resulting from a study that examined smoking characteristics and treatment approaches of 259 participants, 197 of whom were cigarette smokers. RESULTS The survey participants' age of tobacco initiation ranged from 7 to 45 years of age. Participants smoked between 1 and 40 cigarettes per day; the mean number of cigarettes smoked per day was 10.37. Men released from prison used cigarettes for more years on average than men released from jail (t[194] = -2.22, p < .05). A linear regression procedure revealed that the influence of friends and family significantly predicted smoking behavior (β = .25, p < .0001). The qualitative data revealed the following themes: unintended consequences of the prison smoking ban, smoking as anxiety management, smoking cigarettes as part of a daily routine, and barriers to quitting. CONCLUSIONS Given the rapid growth of individuals under community supervision, public health and policy makers are missing an opportunity to develop strategies that promote smoking cessation treatments, especially among men who are serving parole or probation and during the incarceration period itself.
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Affiliation(s)
- Pamela Valera
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY
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van den Berg JJ, Bock B, Roberts MB, Stein LAR, Friedmann PD, Martin SA, Clarke JG. Cigarette smoking as an expression of independence and freedom among inmates in a tobacco-free prison in the United States. Nicotine Tob Res 2013; 16:238-42. [PMID: 24151140 DOI: 10.1093/ntr/ntt163] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Most adults report initiation of cigarette smoking during adolescence, a time also marked by developmental striving for independence and freedom. Tobacco use may retain its association with independence and/or freedom into adulthood. This association may contribute to continued tobacco use and/or increased risk of relapse to smoking among some individuals. This study examines the relationship between cigarette smoking and perceptions of independence and freedom among inmates in a tobacco-free prison in the northeastern United States. METHODS Questionnaires administered to 247 male and female inmates 6 weeks prior to scheduled prison release assessed demographics, smoking history, nicotine dependence, attitudes toward smoking, and plans for tobacco use or abstinence after prison release. Perceptions of smoking as an expression of independence and freedom were measured using 2 items. Smoking was assessed 3 weeks postrelease. RESULTS Constructs of freedom and independence were correlated but did not overlap completely. Both constructs were negatively associated with plans for smoking abstinence after prison release, and with perceived costs of continued smoking. Number of cigarettes smoked postrelease and perception of the pros of smoking were associated with freedom, but not independence. CONCLUSIONS Associations of smoking as an expression of freedom and independence may negatively influence plans for renewed smoking after a forced abstinence. Additional research is needed to determine the degree to which these 2 constructs predict smoking behavior and whether they can be used to improve interventions for incarcerated smokers.
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Bock B, Lopes CE, van den Berg JJ, Roberts MB, Stein LAR, Martin RA, Martin SA, Clarke JG. Social support and smoking abstinence among incarcerated adults in the United States: a longitudinal study. BMC Public Health 2013; 13:859. [PMID: 24044880 PMCID: PMC4015823 DOI: 10.1186/1471-2458-13-859] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 09/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the United States, tobacco use among prisoners is nearly three times that of the general population. While many American prisons and jails are now tobacco-free, nearly all inmates return to smoking as soon as they are released back into the community. METHODS To better understand the role that personal relationships may play in enabling return to smoking, we enrolled former-smokers who were inmates in a tobacco-free prison. Baseline assessments were conducted six weeks prior to inmates' scheduled release and included measures of smoking prior to incarceration, motivation, confidence and plans for remaining quit after release. We also assessed global social support (ISEL) and a measure of social support specific to quitting smoking (SSQ). Smoking status was assessed three weeks after prison release and included 7-day point-prevalence abstinence validated by urine cotinine, days to first cigarette and smoking rate. RESULTS A diverse sample comprised of 35% women, 20% Hispanic, and 29% racial minorities (average age 35.5 years) provided baseline data (n = 247). Over 90% of participants provided follow up data at 3-weeks post-release. Prior to incarceration participants had smoked an average of 21.5 (SD = 11.7) cigarettes per day. Only 29.2% had definite plans to remain smoking-abstinent after release. Approximately half of all participants reported that "most" or "all" of their family (42.2%) and friends (68%) smoked, and 58.8% reported their spouse or romantic partner smoked.SSQ scores were not significantly predictive of smoking outcomes at three weeks, however, social support from family and friends were each significantly and positively correlated with motivation, confidence, and plans for remaining abstinent (all p values <0.05). These smoking-related attitudinal variables were significantly predictive of smoking outcomes (all p values <0.01). General social support (ISEL) was not associated with smoking-related attitudinal variables or smoking outcomes. CONCLUSIONS Inmates of smoke-free prisons have a head-start on being smoke-free for life. They have been abstinent well past the duration of nicotine withdrawal and have great financial incentive not to begin smoking again. However, this advantage may be offset by a lack of non-smoking role models among their family and friends, and perceived lack of support for remaining smoke-free. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01684995.
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Affiliation(s)
- Beth Bock
- Alpert Medical School – Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 167 Point Street, Providence, RI 02903, USA
- The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA
| | - Cheryl E Lopes
- Rhode Island Department of Corrections, 40 Howard Avenue, Cranston, RI 02920, USA
| | - Jacob J van den Berg
- Alpert Medical School – Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 167 Point Street, Providence, RI 02903, USA
| | - Mary B Roberts
- Memorial Hospital of RI, Brown University Center for Primary Care & Prevention, Pawtucket, RI 02860, USA
| | - LAR Stein
- University of Rhode Island, Social Sciences Research Center, 130 Flagg Road, Kingston, RI 02881, USA
| | - Rosemarie A Martin
- Brown University, Center for Alcohol and Addictions Studies, 121 South Main Street, Providence, RI 02903, USA
| | - Stephen A Martin
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 151 Worcester Road, Barre, MA 01005, USA
| | - Jennifer G Clarke
- Center for Primary Care and Prevention, Memorial Hospital of RI, 111 Brewster Street, Pawtucket, RI 02860, USA
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Clarke JG, Stein LAR, Martin RA, Martin SA, Parker D, Lopes CE, McGovern AR, Simon R, Roberts M, Friedman P, Bock B. Forced smoking abstinence: not enough for smoking cessation. JAMA Intern Med 2013; 173:789-94. [PMID: 23567902 PMCID: PMC4438989 DOI: 10.1001/jamainternmed.2013.197] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Millions of Americans are forced to quit smoking as they enter tobacco-free prisons and jails, but most return to smoking within days of release. Interventions are needed to sustain tobacco abstinence after release from incarceration. OBJECTIVE To evaluate the extent to which the WISE intervention (Working Inside for Smoking Elimination), based on motivational interviewing (MI) and cognitive behavioral therapy (CBT), decreases relapse to smoking after release from a smoke-free prison. DESIGN Participants were recruited approximately 8 weeks prior to their release from a smoke-free prison and randomized to 6 weekly sessions of either education videos (control) or the WISE intervention. SETTING A tobacco-free prison in the United States. PARTICIPANTS A total of 262 inmates (35% female). MAIN OUTCOME MEASURE Continued smoking abstinence was defined as 7-day point-prevalence abstinence validated by urine cotinine measurement. RESULTS At the 3-week follow-up, 25% of participants in the WISE intervention (31 of 122) and 7% of the control participants (9 of 125) continued to be tobacco abstinent (odds ratio [OR], 4.4; 95% CI, 2.0-9.7). In addition to the intervention, Hispanic ethnicity, a plan to remain abstinent, and being incarcerated for more than 6 months were all associated with increased likelihood of remaining abstinent. In the logistic regression analysis, participants randomized to the WISE intervention were 6.6 times more likely to remain tobacco abstinent at the 3-week follow up than those randomized to the control condition (95% CI, 2.5-17.0). Nonsmokers at the 3-week follow-up had an additional follow-up 3 months after release, and overall 12% of the participants in the WISE intervention (14 of 122) and 2% of the control participants (3 of 125) were tobacco free at 3 months, as confirmed by urine cotinine measurement (OR, 5.3; 95% CI, 1.4-23.8). CONCLUSIONS AND RELEVANCE Forced tobacco abstinence alone during incarceration has little impact on postrelease smoking status. A behavioral intervention provided prior to release greatly improves cotinine-confirmed smoking cessation in the community. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01122589.
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Affiliation(s)
- Jennifer G Clarke
- Brown University Center for Primary Care and Prevention, Pawtucket, Rhode Island, USA.
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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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