Poster presented at TSRC 2022 by Cheryl K. Olson, M.P.H., Sc.D, Neil Sherwood, Ph.D, and Willie McKinney, Ph.D.
Smoking in the United States is increasingly concentrated among marginalized populations. This includes persons with low incomes and chronic physical or mental disorders, who are especially vulnerable to smoking-related diseases [1]. The prevalence of smoking is about four times higher among people in custody in the U.S. compared to the general population, with studies finding 50-83 percent of prisoners are smokers [2]. Globally, smoking prevalence among people in custody is between 64 and more than 90 percent, depending upon the country and setting [3].
In addition to nicotine, incarcerated persons use a variety of mood-altering substances. For example, nearly two-thirds (64%) of state and federal prisoners reported using at least one drug in the 30 days prior to arrest for the offense for which they were serving time, and half (49%) of state prisoners met the criteria for having a substance use disorder [4].
The stresses and boredom of incarceration, combined with reduced or non-availability of other substances people may have used to cope before imprisonment, appear to push many toward increased smoking. As a World Health Organization report on prison health noted [3], “Tobacco use is completely entangled in prison life where it helps to cope with boredom, deprivation or stress, relieve anxiety and tension and function as a source of pleasure or monetary value in an environment without currency.”
Policies and medications typically used to counter smoking can be ineffective or even counterproductive in prison/jail settings. Some correctional facilities ban combustible cigarettes due to concerns about health effects of second-hand smoke. One U.S. study found that 76 percent of incarcerated male smokers continued to smoke following a prison smoking ban [5]. Bans also reportedly create robust black markets in combustible cigarettes. Studies in Australia, New Zealand and Canada have reported smoking of nicotine patches and lozenges provided to prisoners for smoking cessation (e.g., Puljevic et al., 2018 [6]).
Some correctional facilities have attempted to avoid these problems by substituting ecigarettes for combustible cigarettes. Reviews of randomized controlled trials have found ecigarettes to be more effective than nicotine replacement therapies in encouraging smokers to quit [7].
Several companies have created e-cigarette products specially designed for use in correctional settings, e.g., metal-free, transparent, and with tracking barcodes. Here we describe results of a survey regarding one such product, called eCig4Inmate™.
Read the results by downloading the poster presentation below
Downloadable poster prepared by Karin Gilligan