Abstract
We examined the relationship between having a history of incarceration and being a current smoker using a national sample of noninstitutionalized Black adults living in the United States. With data from the National Survey of American Life collected between February 2001 and March 2003, we calculated individual propensity scores for having a history of incarceration. To examine the relationship between prior incarceration and current smoking status, we ran gender-specific propensity-matched fitted logistic regression models. A history of incarceration was consistently and independently associated with a higher risk of current tobacco smoking in men and women. Formerly incarcerated Black men had 1.77 times the risk of being a current tobacco smoker than did their counterparts without a history of incarceration (95% confidence interval [CI] = 1.20, 2.61) in the propensity score-matched sample. The results were similar among Black women (prevalence ratio = 1.61; 95% CI = 1.00, 2.57). Mass incarceration likely contributes to the prevalence of smoking among US Blacks. Future research should explore whether the exclusion of institutionalized populations in national statistics obscures Black-White disparities in tobacco smoking.
Highlights
As a population, people who have been incarcerated have a greater likelihood of having problems with substance abuse, psychiatric illness, and stressful or traumatic life events, Objectives
The results were similar among Black women
Future research should explore whether the exclusion of institutionalized populations in national statistics obscures Black– White disparities in tobacco smoking. (Am J Public Health. 2015;105:2275–2282. doi:10.2105/AJPH.2015.302772)
Summary
With data from the National Survey of American Life collected between February 2001 and March 2003, we calculated individual propensity scores for having a history of incarceration. We used data from the National Survey of American Life (NSAL), a multistage, crosssectional study that is part of the Collaborative Psychiatric Epidemiology Surveys. The sample included noninstitutionalized Englishspeaking adults aged 18 years and older residing in the 48 contiguous United States between February 2001 and March 2003. The survey targeted non-Caribbean Blacks, Caribbean Blacks, and non-Hispanic Whites living in urban, rural, and suburban areas where Black Americans are residentially concentrated within the secondary stage of area sampling, which was stratified at the county level.[23,24] Non-Hispanic Whites were not surveyed about their tobacco use and, we excluded them from our study. More details about the design and characteristics associated with the NSAL are given elsewhere.23---26
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