New Findings Reveal a Need for Change in Correctional Facilities

Hands rest on prison bars

Fewer and fewer people who are incarcerated are engaging with smoking cessation treatments, according to findings published in Preventive Medicine Reports; as this population becomes harder to reach, it becomes clear that current intervention strategies are failing to meet their needs.

“Not many people look at the intersection of criminality and tobacco use,” said Kari Ives, correctional social worker for the Department of Corrections, “but we’ve been at it a long time. People need to realize the strength of nicotine: it’s something this population always returns to, it’s so easy and available, and not many addiction treatment programs (in correctional facilities teach about it.”

Researchers conducted surveys of nearly 5,300 people who are incarcerated over nine years, averaging just under 588 respondents yearly. All of the surveys were done at the same Midwestern correctional facility, a facility with a complete tobacco ban; many of the people who are incarcerated who smoke are forced to quit cold-turkey.

“Nicotine and tobacco are often thought about as something else, something that doesn’t relate to other types of addiction,” said Ives, “When in group, people who are incarcerated talk about how they can’t wait to get out and have a cigarette, and when they’re on probation or parole they’re allowed to smoke. If, in treatment, we don’t discuss the biopsychosocial properties of nicotine addiction—if we only look at the physical by having them quit cold turkey—it’s like a pause button, which I believe can lead them back to square one with smoking.”

From 2012 to 2020, more than 85% of respondents reported they had ever smoked, with more than 95% reporting they smoked daily. This is a sharp contrast from general smoking trends among adults in the US, where smoking has been declining.

In 2012, 32.6% of respondents replied “yes” when asked if they wanted help remaining smoke free. In 2020, that number dropped below nine percent.

“When I started on this project,” said Dr. Jesse Kaye, UW-CTRI researcher, “I conducted a literature review, looking at the existing studies on nicotine addiction among people who are incarcerated. There was such a limited number of studies on interventions to support people remaining tobacco-free when they return to their community.

Allison Gorrilla
Allison Gorrilla

“We need to better understand what type of support this population wants to remain tobacco-free. The exceptionally high and stable rates of tobacco use prior to incarceration represents a growing health disparity when compared to the rates of tobacco use in the general adult population that continue to decline.”

Research indicates that 60 to 90 percent of people who are incarcerated will resume smoking after their release, revealing a disconnect between the correctional facility’s available cessation aid and what this vulnerable population actually needs.

“We’ve been working on a response,” said UW-CTRI Regional Outreach Specialist (ROS) Allison Gorrilla. All four ROS are collaborating with the Department of Corrections to develop a training for the 36 correctional facilities throughout the state.

“It’s clear that forced abstinence isn’t sufficient. Fortunately, correctional facilities are already providing substance use disorder treatment: counseling around coping strategies, problem solving, and relapse prevention. A goal of our training is to help staff use these treatment interventions to help people with a history of tobacco use stay tobacco-free upon release.

“We know there’s a need. Let’s use this as an opportunity.”