Researchers highlight need for more smoking cessation programs in state prisons

Inmates want to quit smoking but don't have access to smoking cessation programs in state prisons, increasing the risk—especially among black male inmates—of cancer, heart disease, stroke and other smoking-related diseases, according to Rutgers researchers.

In a study published in Health Psychology Open, researchers examined smoking behaviors and characteristics of 169 black and non-black male inmates in three state correctional facilities in the Northeast to identify racial differences in their smoking behaviors and motivation to quit. Some previous studies suggest that black male smokers—in and out of prison—may be less likely to respond to treatment than other racial and ethnic groups despite their stronger desire to quit.

"Our study will help health researchers and smoking cessation treatment specialists to better understand the smoking behaviors of inmates—why they begin and continue to smoke—in order to better tailor and implement important cessation programs to assist them in quitting for life," said lead author Pamela Valera, an assistant professor at Rutgers School of Public Health.

Statistics show that black men are six times more likely to be imprisoned than non-Hispanic white men. They also face higher rates of cigarette smoking both in and out of prison and are more likely to die from smoking-related diseases.

Given the high rates of tobacco related problems in U.S. prisons and racial disparity, relapse to smoking is common among black inmates and black men returning to society. Valera said many prisons could add additional resources to help inmates quit tobacco smoke but have instead introduced smoking bans, which cannot prevent inmate from smoking or prevent them from returning to smoking after their release.

"Despite the number of different smoking cessation aids available, less than half of the people in both study groups had a medical professional in prison talk to them about quitting," said Valera. "Many of these inmates want to quit. They just lack the means and understanding on how to do so."

Valera's recommendations include:

• Tobacco dependence treatments to help people quit using cigarettes and other tobacco products, including menthol cigarettes, which are popular among black smokers in and out of prison.
• Prison-wide smoking cessation programs that reduce negative peer influence and help inmates who want to quit smoking live with cellmates who still smoke.
• Help inmates who have quit smoking to be a positive influence on other inmates.

The smoking behavior trends found in the study include:

• Smoking rates were high among both black and non-black inmates, who began or continued to smoke in prison.
• Both groups want to quit smoking, although black smokers were slightly more interested.
• While cigarettes were the most frequently used tobacco product, both groups use other products, including pipes, cigars and chew/snuff, although non-black smokers were slightly more likely to use them.
• Menthol cigarette use was high among both groups.
• Among people in both groups who had tried to quit smoking, many indicated it had been at least a year or more since they last attempted to quit, and a majority of smokers in both groups who were able to quit relapsed within less than a year.
• A majority of people in both groups had not used any form of smoking cessation treatment to help them quit.
• More than half of people in both groups reported that their cellmate smokes around them.