Abstract
BackgroundIncarcerated individuals suffer disproportionately from the health effects of tobacco smoking due to the high smoking prevalence in this population. In addition there is an over-representation of ethnic and racial minorities, impoverished individuals, and those with mental health and drug addictions in prisons. Increasingly, prisons across the U.S. are becoming smoke free. However, relapse to smoking is common upon release from prison, approaching 90% within a few weeks. No evidence based treatments currently exist to assist individuals to remain abstinent after a period of prolonged, forced abstinence.Methods/DesignThis paper describes the design and rationale of a randomized clinical trial to enhance smoking abstinence rates among individuals following release from a tobacco free prison. The intervention is six weekly sessions of motivational interviewing and cognitive behavioral therapy initiated approximately six weeks prior to release from prison. The control group views six time matched videos weekly starting about six weeks prior to release. Assessments take place in-person 3 weeks after release and then for non-smokers every 3 months up to 12 months. Smoking status is confirmed by urine cotinine.DiscussionEffective interventions are greatly needed to assist these individuals to remain smoke free and reduce health disparities among this socially and economically challenged group.Trial RegistrationNCT01122589
Highlights
Incarcerated individuals suffer disproportionately from the health effects of tobacco smoking due to the high smoking prevalence in this population
Quitting smoking reduces the risks of developing smoking related illnesses as well as the morbidity and mortality associated with these illnesses
This study is designed to evaluate the effects of an Intensive Behavioral Intervention (IBI, which combines Motivational Interviewing (MI)+cognitive behavioral therapy (CBT)) on post-release smoking abstinence rates as well as motivation to remain abstinent among a population of incarcerated men and women who had smoked prior to incarceration and are scheduled to be released
Summary
Tobacco use contributes to over 400,000 deaths annually [1]. It is a major contributor to both cancer and heart disease risk, and is the leading cause of preventable morbidity, mortality and health expense in the United States [2]. One approach that has demonstrated efficacy and effectiveness for assisting in smoking cessation and maintenance is cognitive behavioral therapy (CBT) [8,9]. This approach teaches skills that enhance the individual’s ability to cope with challenges and remain smoke free. We chose to enhance a CBT-based intervention with additional sessions of Motivational Interviewing (MI), to enhance interest in remaining smoke free so that skills will be learned and utilized post-release from incarceration [10,11]. This study is designed to evaluate the effects of an Intensive Behavioral Intervention (IBI, which combines MI+CBT) on post-release smoking abstinence rates as well as motivation to remain abstinent among a population of incarcerated men and women who had smoked prior to incarceration and are scheduled to be released
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