Group-based smoking cessation help US inmates quit tobacco

Behavioral and nicotine replacement therapies offered together can help people who are incarcerated quit smoking, according to Rutgers researchers.

The study published in the American Journal of Men's Health, found that the combination of group-based tobacco dependence treatment and nicotine replacement therapy was an effective and feasible option to reduce tobacco dependence among men who were incarcerated and transgender women who face significant barriers to accessing smoking cessation treatment services.

"Smokers who are incarcerated, similar to other marginalized populations who smoke, lack the necessary skills to quit and have limited access to treatment options," said Pamela Valera, an assistant professor in the Department of Urban-Global Public Health at the Rutgers School of Public Health. "Without smoke cessation resources and treatment, only 5 percent of those who quit will achieve long-term success."

In the United States, people who are incarcerated smoke tobacco products, including cigarettes, at disproportionately higher rates than the general adult population, which can be attributed to behavioral health conditions and mental health symptoms. People who are incarcerated are likely to use tobacco products. They use tobacco products to cope with chronic and daily stress caused by missing family and friends, lack of freedom, prison lockdowns, long periods of boredom, interaction with correctional officers and medical staff, and stressful events due to incarceration itself.

The study—which took place over six weeks—included 177 male and transgender female inmates from seven prisons. Inmates over age 18 who smoked at least five cigarettes per day over the previous week received nicotine replacement therapy in the form of patches and weekly group smoking cessation treatment. The treatment included sessions on cognitive social learning, lifestyle changes, coping, healthy decision-making, maintenance and relapse prevention, and long-term abstinence.

Inmates who completed the six-week program reduced tobacco smoking or quit all together, suggesting the program may be promising for future larger-scale studies.

"By providing inmates the space to share their experiences surrounding nicotine withdrawal and nicotine dependence, many were able to learn coping strategies, identify their triggers, express their emotions with stressors while incarcerated and become supporters of each other's quit journey," said Nicholas Acuna, a Rutgers School of Public Health alumnus.