Smoking in Correctional Settings Worldwide: Prevalence, Bans, and Interventions

Area of Science:

• Public Health
• Epidemiology
• Criminology

Background:

• Tobacco use is a leading cause of preventable death worldwide.
• Incarcerated populations often exhibit higher smoking rates compared to the general community.
• Understanding global smoking prevalence in prisons is crucial for public health interventions.

Purpose of the Study:

• To systematically review and determine the global prevalence of smoking among incarcerated individuals.
• To examine prison policies regarding smoking bans and cessation treatments.
• To estimate the number of smokers passing through prisons annually.

Main Methods:

• Systematic literature review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Searched databases for articles published between 2012 and 2016.
• Included 85 articles representing data from 50 countries and 73.5% of the global incarcerated population.

Main Results:

• Smoking prevalence in prisons exceeded community rates in 97% of nations with data, ranging from 1.04- to 62.6-fold higher.
• An estimated 14.5 million men and 26,000 women who smoke pass through prisons annually.
• Prison smoking bans have limited long-term impact post-release, while evidence-based cessation interventions show sustained effectiveness.

Conclusions:

• Prisons represent a critical setting for addressing high smoking rates due to significantly elevated prevalence.
• Implementing evidence-based smoking cessation programs within correctional facilities offers a substantial opportunity to improve global health.
• Interventions effective outside prisons are also effective for incarcerated individuals, with lasting benefits after release.