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Tobacco Use Among People Who Have Been in Prison: Relapse and Factors Associated with Trying to Quit

Published online by Cambridge University Press:  16 March 2016

Michael R. Frank*
Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
Rachel Blumhagen
Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO
David Weitzenkamp
Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO
Shane R. Mueller
Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
Brenda Beaty
Colorado Health Outcomes Program, University of Colorado Anschutz Medical Campus; Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, CO
Sung-Joon Min
Division of Health Care Policy and Research, University of Colorado School of Medicine, Aurora, CO
Ingrid A. Binswanger
Institute for Health Research, Kaiser Permanente Colorado, Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
Address for correspondence: Michael R. Frank, Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Mailstop B180, 12631 E 17th Avenue, Aurora, CO 80025, USA. Email:


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.

Original Articles
Copyright © The Author(s) 2016 

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