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Mohammed LI, Razali R, Zakaria ZZ, Benslimane FM, Cyprian F, Al-Asmakh M. Smoking induced salivary microbiome dysbiosis and is correlated with lipid biomarkers. BMC Oral Health 2024; 24:608. [PMID: 38796419 PMCID: PMC11127352 DOI: 10.1186/s12903-024-04340-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/07/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND The oral microbiome plays an essential role in maintaining oral homeostasis and health; smoking significantly affects it, leading to microbial dysbiosis. The study aims to investigate changes in the oral microbiome composition of smokers in the Qatari population and establish a correlation with lipid biomarkers. METHODS The oral microbiota was profiled from saliva samples of 200 smokers and 100 non-smokers in the Qatari population, and 16s rRNA V3-V4 region were sequenced using the Illumina MiSeq platform. The operational taxonomic units (OTUs) were clustered using QIIME and the statistical analysis was performed by R. RESULTS Non-smokers exhibited a more diverse microbiome, with significant alpha and beta diversity differences between the non-smoker and smoker groups. Smokers had a higher abundance of Firmicutes, Bacteroidota, Actinobacteriota, Patescibacteria, and Proteobacteria at the phylum level and of Streptococcus, Prevotella, Veillonella, TM7x, and Porphyromonas at the genus level. In contrast, non-smokers had more Bacteroidota, Firmicutes, Proteobacteria, Fusobacteriota, and Patescibacteria at the phylum level, and Prevotella, Streptococcus, Veillonella, Porphromonas, and Neisseria at the genus level. Notably, Streptococcus was significantly positively correlated with LDL and negatively correlated with HDL. Additionally, Streptococcus salivarius, within the genus Streptococcus, was substantially more abundant in smokers. CONCLUSION This study highlights the significant influence of smoking on the composition of the oral microbiome by enriching anaerobic microbes and depleting aerobic microbes. Moreover, the observed correlation between Streptococcus abundance and the lipid biomarkers suggests a potential link between smokers-induced salivary microbiome dysbiosis and lipid metabolism. Understanding the impact of smoking on altering the oral microbiome composition and its correlation with chemistry tests is essential for developing targeted interventions and strategies to improve oral health and reduce the risk of diseases.
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Affiliation(s)
- Layla I Mohammed
- Department of Biomedical Sciences, College of Health Science, QU-Health, Qatar University, PO Box 2713, Doha, Qatar
- Biomedical Research Center, Qatar University, Doha, 2713, Qatar
| | - Rozaimi Razali
- Department of Biomedical Sciences, College of Health Science, QU-Health, Qatar University, PO Box 2713, Doha, Qatar
- The KINDI Center for Computing Research, College of Engineering, Qatar University, Doha, Qatar
| | - Zain Zaki Zakaria
- Medical and Health Sciences Office, QU-Health, Qatar University, PO Box 2713, Doha, Qatar
| | | | - Farhan Cyprian
- Basic Medical Science Department, College of Medicine-QU Health, Qatar University, Doha, 2713, Qatar
| | - Maha Al-Asmakh
- Department of Biomedical Sciences, College of Health Science, QU-Health, Qatar University, PO Box 2713, Doha, Qatar.
- Biomedical Research Center, Qatar University, Doha, 2713, Qatar.
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Borschmann R, Kinner SA. Rates and causes of death after release from incarceration among 1 471 526 people in eight high-income and middle-income countries: an individual participant data meta-analysis. Lancet 2024; 403:1779-1788. [PMID: 38614112 DOI: 10.1016/s0140-6736(24)00344-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 02/06/2024] [Accepted: 02/16/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Formerly incarcerated people have exceptionally poor health profiles and are at increased risk of preventable mortality when compared with their general population peers. However, not enough is known about the epidemiology of mortality in this population-specifically the rates, causes, and timing of death in specific subgroups and regions-to inform the development of targeted, evidence-based responses. We aimed to document the incidence, timing, causes, and risk factors for mortality after release from incarceration. METHODS We analysed linked administrative data from the multi-national Mortality After Release from Incarceration Consortium (MARIC) study. We examined mortality outcomes for 1 471 526 people released from incarceration in eight countries (Australia, Brazil, Canada, New Zealand, Norway, Scotland, Sweden, and the USA) from 1980 to 2018, across 10 534 441 person-years of follow-up (range 0-24 years per person). We combined data from 18 cohort studies using two-step individual participant data meta-analyses to estimate pooled all-cause and cause-specific crude mortality rates (CMRs) per 100 000 person-years, for specific time periods (first, daily from days 1-14; second, weekly from weeks 3-12; third, weeks 13-52 combined; fourth, weeks 53 and over combined; and fifth, total follow-up) after release, overall and stratified by age, sex, and region. FINDINGS 75 427 deaths were recorded. The all-cause CMR during the first week following release (1612 [95% CI 1048-2287]) was higher than during all other time periods (incidence rate ratio [IRR] compared with week 2: 1·5 [95% CI 1·2-1·8], I2=26·0%, weeks 3-4: 2·0 [1·5-2·6], I2=53·0%, and weeks 9-12: 2·2 [1·6-3·0], I2=70·5%). The highest cause-specific mortality rates during the first week were due to alcohol and other drug poisoning (CMR 657 [95% CI 332-1076]), suicide (135 [36-277]), and cardiovascular disease (71 [16-153]). We observed considerable variation in cause-specific CMRs over time since release and across regions. Pooled all-cause CMRs were similar between males (731 [95% CI 630-839]) and females (660 [560-767]) and were higher in older age groups. INTERPRETATION The markedly elevated rate of death in the first week post-release underscores an urgent need for investment in evidence-based, coordinated transitional healthcare, including treatment for mental illness and substance use disorders to prevent post-release deaths due to suicide and overdose. Temporal variations in rates and causes of death highlight the need for routine monitoring of post-release mortality. FUNDING Australia's National Health and Medical Research Council.
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Affiliation(s)
- Rohan Borschmann
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia; Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK; Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Justice Health Group, enAble Institute, Curtin University, Perth, WA, Australia.
| | - Stuart A Kinner
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Justice Health Group, enAble Institute, Curtin University, Perth, WA, Australia; Griffith Criminology Institute, Griffith University, Brisbane, QLD, Australia
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Favril L, Rich JD, Hard J, Fazel S. Mental and physical health morbidity among people in prisons: an umbrella review. Lancet Public Health 2024; 9:e250-e260. [PMID: 38553144 DOI: 10.1016/s2468-2667(24)00023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND People who experience incarceration are characterised by poor health profiles. Clarification of the disease burden in the prison population can inform service and policy development. We aimed to synthesise and assess the evidence regarding the epidemiology of mental and physical health conditions among people in prisons worldwide. METHODS In this umbrella review, five bibliographic databases (Web of Science, PubMed, PsycINFO, Embase, and Global Health) were systematically searched from inception to identify meta-analyses published up to Oct 31, 2023, which examined the prevalence or incidence of mental and physical health conditions in general prison populations. We excluded meta-analyses that examined health conditions in selected or clinical prison populations. Prevalence data were extracted from published reports and study authors were contacted for additional information. Estimates were synthesised and stratified by sex, age, and country income level. The robustness of the findings was assessed in terms of heterogeneity, excess significance bias, small-study effects, and review quality. The study protocol was pre-registered with PROSPERO, CRD42023404827. FINDINGS Our search of the literature yielded 1909 records eligible for screening. 1736 articles were excluded and 173 full-text reports were examined for eligibility. 144 articles were then excluded due to not meeting inclusion criteria, which resulted in 29 meta-analyses eligible for inclusion. 12 of these were further excluded because they examined the same health condition. We included data from 17 meta-analyses published between 2002 and 2023. In adult men and women combined, the 6-month prevalence was 11·4% (95% CI 9·9-12·8) for major depression, 9·8% (6·8-13·2) for post-traumatic stress disorder, and 3·7% (3·2-4·1) for psychotic illness. On arrival to prison, 23·8% (95% CI 21·0-26·7) of people met diagnostic criteria for alcohol use disorder and 38·9% (31·5-46·2) for drug use disorder. Half of those with major depression or psychotic illness had a comorbid substance use disorder. Infectious diseases were also common; 17·7% (95% CI 15·0-20·7) of people were antibody-positive for hepatitis C virus, with lower estimates (ranging between 2·6% and 5·2%) found for hepatitis B virus, HIV, and tuberculosis. Meta-regression analyses indicated significant differences in prevalence by sex and country income level, albeit not consistent across health conditions. The burden of non-communicable chronic diseases was only examined in adults aged 50 years and older. Overall, the quality of the evidence was limited by high heterogeneity and small-study effects. INTERPRETATION People in prisons have a specific pattern of morbidity that represents an opportunity for public health to address. In particular, integrating prison health within the national public health system, adequately resourcing primary care and mental health services, and improving linkage with post-release health services could affect public health and safety. Population-based longitudinal studies are needed to clarify the extent to which incarceration affects health. FUNDING Research Foundation-Flanders, Wellcome Trust, National Institutes of Health.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Josiah D Rich
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
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Weng X, Ma EC, Song CY, Lee JJ, Tong HSC, Lai VWY, Lam TH, Wang MP. Experiences of quitting smoking in prisons: A qualitative study of people in custody. Tob Induc Dis 2024; 22:TID-22-43. [PMID: 38375095 PMCID: PMC10875655 DOI: 10.18332/tid/183604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION Smoking prevalence among people in custody (PIC) is extremely high, and prison-based smoking cessation interventions are needed. The study explored the quitting experiences of PIC who participated in the 'Quit to Win' contest (QTW). METHODS This qualitative study, conducted from 2019 to 2021 in two Hong Kong prisons, included semi-structured individual interviews with 26 PIC (13 men and 13 women) who were participants in QTW and two correctional staff who coordinated QTW. A semi-structured interview guide with open-ended questions was developed to examine multilevel factors that promote or impede smoking cessation in prisons. Maximum variation sampling was used to ensure a diverse range of social, demographic, and smoking profiles. Data were managed and analyzed using thematic analysis. RESULTS Two themes were identified from the data: 1) quitting in prison: barriers and facilitators; and 2) QTW in prison: a trigger for behavior change. Barriers (i.e. stress, boredom, isolation, lack of self-autonomy, nicotine dependence and lack of cessation medication, barriers to moving to a different wing) and facilitators (i.e. concerns about health, money savings, and the smoke-free wing) that impeded or supported smoking cessation during incarceration were identified. QTW provided health education, quitting incentives, and social support that helped PIC overcome the barriers of quitting by serving as a trigger for behavior change. Notably, social visits with family were identified as key drivers of PIC's quitting success, whereas their suspension during the COVID-19 pandemic disincentivized their abstinence. CONCLUSIONS This study introduced the QTW contest to prisons and provided qualitative evidence on the multilevel factors promoting or impeding smoking cessation in prison. QTW helped PIC overcome the barriers of quitting by serving as a trigger for behavior change. Future prison-based interventions should leverage social support, enhance stress-coping skills, facilitate access to pharmacotherapy, and collaborate with correctional services agencies.
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Affiliation(s)
- Xue Weng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
| | - Emily Ching Ma
- School of Public Health, Brown University, United States
| | - Chu Yu Song
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
| | | | | | - Tai Hing Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
| | - Man Ping Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China
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Svendsen VG, Bukten A, Skardhamar T, Stavseth MR. Mortality in women with a history of incarceration in Norway: a 20-year national cohort study. Int J Epidemiol 2024; 53:dyae032. [PMID: 38481122 PMCID: PMC10937902 DOI: 10.1093/ije/dyae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/16/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Women carry a substantial burden of psychiatric, somatic and lifestyle-related morbidity in the prison context. By describing causes of death and estimating the risk and burden of mortality compared with the general population, this study investigates how mortality operates in this highly marginalized and under-researched population. METHODS In this registry-based study of all women incarcerated in Norwegian prisons from 2000 to 2019 (N = 11 313), we calculated crude mortality rates, years of lost life and, by using mortality in age-matched women from the general population as a reference, age-standardized mortality ratios and years of lost life rates. RESULTS Over a mean follow-up time of 10.7 years, at a median age of 50 years, 9% of the population had died (n = 1005). Most deaths (80%) were premature deaths from an avoidable cause. Drug-induced causes and deaths from major non-communicable diseases (NCDs) were most frequent (both 32%). Compared with women in the general population, women with a history of incarceration were more likely to die from any cause. Trends in annual age-standardized years of lost life rates suggest that the mortality burden associated with major NCDs has gradually replaced drug-induced causes. CONCLUSIONS Women with a history of incarceration die at a greater rate than their peers and largely from avoidable causes. The profile of causes contributing to the substantial burden of mortality placed on this population has changed over time and has important implications for future efforts to reduce morbidity and the risk of premature death following release from prison.
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Affiliation(s)
- Vegard G Svendsen
- Norwegian Centre for Addiction Research, SERAF, University of Oslo, Oslo, Norway
| | - Anne Bukten
- Norwegian Centre for Addiction Research, SERAF, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torbjørn Skardhamar
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
| | - Marianne Riksheim Stavseth
- Norwegian Centre for Addiction Research, SERAF, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Valera P, Malarkey S, Smith N, McLaughlin C. Exploring the role of telehealth: A novel approach to group-based smoking cessation treatment for men incarcerated in a rural state prison. J Telemed Telecare 2024; 30:142-150. [PMID: 34524911 DOI: 10.1177/1357633x211034734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Tobacco smoking remains an important public health issue in the United States (US), specifically among people who are incarcerated. There is little to no information about smoking behaviors of incarcerated people in rural areas and there is a lack of resources for smoking cessation interventions in rural settings. Telehealth might be efficient for delivering care to incarcerated people in rural areas. The purpose of this study was to determine the feasibility of delivering group-based smoking cessation treatment via telehealth to incarcerated male smokers in a rural prison. METHODS A 6-week group-based smoking cessation treatment program was conducted with 1-month follow up. Video conferencing was used from Weeks 2-5 to deliver treatment. A cross-sectional survey was administered collecting measures including criminal justice experience, smoking behaviors, withdrawal and triggers, mental health, physical health, and substance use. Baseline exhaled carbon monoxide (CO) levels were collected at Session 1, and a final CO level at Session 6 and 1-month follow-up. RESULTS Twenty (n = 20) incarcerated male smokers were recruited from a rural prison facility. The majority of the inmates were White (85%). Approximately, 80% of the inmates smoked about 20 or more cigarettes per day, and on average smoked for 28 years (SD = 9). Most inmates scored a moderate or high dependence score on the Fagerström Test for Nicotine Dependence. CONCLUSION Telehealth programs such as video conferencing smoking cessation treatment ought to be implemented to reduce tobacco-related disparities among incarcerated smokers housed in rural prisons.
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Affiliation(s)
- Pamela Valera
- School of Public Health, Rutgers the State University of New Jersey, USA
| | - Sarah Malarkey
- School of Public Health, Rutgers the State University of New Jersey, USA
| | - Nadia Smith
- School of Public Health, Rutgers the State University of New Jersey, USA
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McMeekin N, Wu O, Boyd KA, Brown A, Tweed EJ, Best C, Craig P, Leyland AH, Demou E, Byrne T, Pell J, Semple S, Sweeting H, Graham L, Hunt K. Implementation of a national smoke-free prison policy: an economic evaluation within the Tobacco in Prisons (TIPs) study. Tob Control 2023; 32:701-708. [PMID: 35256533 PMCID: PMC7615232 DOI: 10.1136/tobaccocontrol-2021-056991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/22/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine the cost-effectiveness of a smoke-free prison policy in Scotland, through assessments of the trade-offs between costs (healthcare and non-healthcare-related expenditure) and outcomes (health and non-health-related non-monetary consequences) of implementing the policy. DESIGN A health economic evaluation consisting of three analyses (cost-consequence, cost-effectiveness and cost-utility), from the perspectives of the healthcare payer, prison service, people in custody and operational staff, assessed the trade-offs between costs and outcomes. Costs associated with the implementation of the policy, healthcare resource use and personal spend on nicotine products were considered, alongside health and non-health outcomes. The cost-effectiveness of the policy was evaluated over 12-month and lifetime horizons (short term and long term). SETTING Scotland's national prison estate. PARTICIPANTS People in custody and operational prison staff. INTERVENTION Implementation of a comprehensive (indoor and outdoor) smoke-free policy. MAIN OUTCOME MEASURES Concentration of secondhand smoke, health-related quality of life (health utilities and quality-adjusted life-years (QALY)) and various non-health outcomes (eg, incidents of assaults and fires). RESULTS The short-term analyses suggest cost savings for people in custody and staff, improvements in concentration of secondhand smoke, with no consistent direction of change across other outcomes. The long-term analysis demonstrated that implementing smoke-free policy was cost-effective over a lifetime for people in custody and staff, with approximate cost savings of £28 000 and £450, respectively, and improvement in health-related quality of life of 0.971 QALYs and 0.262, respectively. CONCLUSION Implementing a smoke-free prison policy is cost-effective over the short term and long term for people in custody and staff.
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Affiliation(s)
- Nicola McMeekin
- HEHTA, Institute of Health and Wellbeing, University of Glasgow College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - Olivia Wu
- HEHTA, Institute of Health and Wellbeing, University of Glasgow College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - Kathleen Anne Boyd
- HEHTA, Institute of Health and Wellbeing, University of Glasgow College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - Ashley Brown
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Emily J Tweed
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Catherine Best
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alastair H Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Tom Byrne
- Healthcare Improvement Scotland, Glasgow, UK
| | - Jill Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | | | - Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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Jayes L, Waddingham J, Britton J, Murray R. A Qualitative Study of the Implementation and Continued Delivery of Complete and Partial Smoke-Free Policies Across England's Prison Estate. Nicotine Tob Res 2023; 25:1099-1108. [PMID: 36629042 PMCID: PMC10202636 DOI: 10.1093/ntr/ntac296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/17/2022] [Accepted: 01/10/2023] [Indexed: 01/12/2023]
Abstract
INTRODUCTION In the United Kingdom, smoking among prisoners is up to five times more prevalent than the national average. Between 2015 and 2018, HMPPS introduced a complete smoke-free policy in all closed prisons, and a partial policy permitting smoking only in smoking shelters in open prisons. AIMS AND METHODS This study aimed to explore the views of stakeholders regarding the implementation and continuation of smoke-free policies, including the management of nicotine addiction during imprisonment and after release. Individuals with key strategic and/or operational roles in delivering smoke-free prison policies across England were purposively sampled to complete a semi-structured interview. Twenty-eight interviews were analyzed thematically. RESULTS The smoke-free implementation across the closed prison estate was viewed as a success, though there were reports of reduced availability of smoking cessation support since the roll out. Participants thought the majority of tobacco smokers living in closed prison environments were now using an electronic cigarette, typically as a temporary means to manage nicotine addiction until release. In open prisons the partial policy has been less successful; high rates of smoking resumption on moving from closed to open conditions were reported, with many participants arguing that the open estate should also go completely smoke free. It was envisaged that most prisoners would resume smoking on community release. CONCLUSIONS The smoke-free policies provide a unique opportunity to promote lifelong cessation in this highly disadvantaged group. However more could be done to adopt a consistent smoke-free policy across all prisons, and to support prisoners in quitting smoking and nicotine use during and after imprisonment. IMPLICATIONS Our results identify the urgent need for more work to explore rates and reasons for relapse to smoking on transfer to the open estate and after release. With the majority of smokers in the closed prison estate now using e-cigarettes to manage their nicotine addiction, one way to support long-term tobacco abstinence could be to place greater emphasis on this switching behavior as a way of reducing tobacco-related harm within this population.
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Affiliation(s)
- Leah Jayes
- Institute of Health and Allied Professions, Nottingham Trent University, Clifton Campus, Nottingham NG11 8NS, UK
| | - Jessica Waddingham
- JJR Macleod Centre for Diabetes, Endocrinology and Metabolism, NHS Grampian, Aberdeen, UK
| | - John Britton
- Population and Lifespan Sciences, School of Medicine, The University of Nottingham, Nottingham, UK
| | - Rachael Murray
- Population and Lifespan Sciences, School of Medicine, The University of Nottingham, Nottingham, UK
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Khalaf A. Smoking, prisons and human rights. REVISTA ESPANOLA DE SANIDAD PENITENCIARIA 2023; 25:43-44. [PMID: 37552272 PMCID: PMC10366707 DOI: 10.18176/resp.00066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Ahmad Khalaf
- Specialist in Internal Medicine. Expert in Tobacco Control. President of the Azahar - Association for the prevention of smoking and its diseasesAzahar - Association for the prevention of smoking and its diseasesMorellaSpain
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10
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Lanzano R, Pelullo CP, Della Polla G, Di Giuseppe G, Pavia M. Perceived health status and satisfaction with healthcare services of detained male individuals: a survey in Italy. Public Health 2023; 214:10-19. [PMID: 36427411 DOI: 10.1016/j.puhe.2022.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/15/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study investigated the perceived health status and satisfaction with prison healthcare services of detained male individuals in Italy. STUDY DESIGN A cross-sectional study was performed between March and June 2021. METHODS Of 800 male detained individuals who were invited to participate in the study, 632 returned the self-administered questionnaire, resulting in a response rate of 79%. RESULTS Overall, 72.8% of participants reported that they were moderately or completely satisfied with their health status, and 27.2% stated that they were not at all satisfied. Moreover, 66.2% of participants reported that they had at least one health problem or disease, compared with 34% at the time of incarceration, with 35% reporting multiple health problems/diseases. In total, 10.1% of participants requested healthcare when a health problem occurred, and 12.4% were always satisfied with the healthcare that they received. Significant determinants of dissatisfaction with health status were older age, reported health problems/diseases, suicide attempts, emotional problems and no working activity in prison. Significant determinants of dissatisfaction with healthcare services were younger age, health problems at incarceration, suicide attempts and multiple experiences of incarceration. CONCLUSIONS This study shows that detained male individuals have multiple and frequently unmet health needs. Some of the reported health problems or diseases were present at the time of incarceration, but these often worsened and/or increased during detention. This study highlights the need to promote evidence-based intervention to strengthen the role of healthcare services provided in prisons.
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Affiliation(s)
- R Lanzano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - C P Pelullo
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - G Della Polla
- Health Direction, Teaching Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Di Giuseppe
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M Pavia
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Delile JM. Tabac et précarité : l’enjeu central de l’accès aux soins. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:69-80. [PMID: 38423965 DOI: 10.3917/spub.pr1.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The prevalence and severity of smoking are particularly high in populations in precarious situations and make smoking an essential determinant of social inequalities in health, due to its particularly catastrophic impact on the health of these populations. The general reduction in smoking, less significant in disadvantaged populations, contributes to further increasing these inequalities, and smoking tends to be concentrated in the most vulnerable populations. The relationships between tobacco and precariousness are examined by identifying, based on a review of the literature, the main common factors of vulnerability: stress and social adversity, self-stigma, a low feeling of self-efficacy, the social function of tobacco use, the ambivalence of demands, associated addictions, the severity of tobacco dependence, distance from support and care systems, etc. Specific attention is paid to certain particular conditions: mental health disorders, addictions (other than tobacco), inadequate housing, detention, migration. On this basis, courses of action are proposed to improve access to care and its effectiveness for the people concerned. Emphasis is placed on the mobilization of professionals who often tend to neglect issues of smoking in view of the immediate severity of the problems at the origin of the demands of the people received. A support offer for harm reduction (vaping in particular) seems particularly suited to often-ambivalent demands. The importance of networking and the involvement of CSAPAs/CAARUDs is also underlined. At the systemic level, all of this must be accompanied by political advocacy to reduce these inequalities and social determinants of health..
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Montanha SDM, Botelho C, Silva AMCD. Prevalence and factors associated with tobacco use in women deprived of liberty in a prison in the Brazilian Midwest. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-812320222712.09242022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract Tobacco use is a Public Health issue, and the release of its use in the prison system is controversial. Its prevalence in this population is high, including in women’s prisons. The objective of this article is to estimate tobacco use prevalence in women deprived of liberty and its associated factors. Cross-sectional study with 259 participants who answered a questionnaire in a prison in the Brazilian Midwest. The dependent variable was tobacco use, and the independent variables were sociodemographic, life history, legal status, and use of other drugs. Descriptive and bivariate analyses were performed, using prevalence ratios through the Chi-square test and Poisson regression in the multivariate analysis. Tobacco use prevalence was 86.87%. In the final model, the variables: age group, from 18-39 years (PR 1.33; 95%CI 1.10-1.61), alcohol use (PR 1.26; 95%CI 1.00-1.59), marijuana use (PR 1.16; 95%CI 1.03-1.30), and interaction between prison time and cocaine use (PR 1.05; 95%CI 1.00-1.11) remained associated with tobacco use. Tobacco use prevalence was high. The age group 18-39 years, alcohol and marijuana use and interaction between imprisonment length of 36 months or more and cocaine use were associated with tobacco use.
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Montanha SDM, Botelho C, Silva AMCD. Prevalência e fatores associados ao tabagismo em mulheres privadas de liberdade, numa prisão, Centro-Oeste do Brasil. CIENCIA & SAUDE COLETIVA 2022; 27:4511-4520. [DOI: 10.1590/1413-812320222712.09242022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 06/17/2022] [Indexed: 12/23/2022] Open
Abstract
Resumo O tabagismo é um problema de Saúde Pública e é controversa a liberação do seu uso no sistema prisional. Sua prevalência nesta população é elevada, inclusive nas prisões femininas. O objetivo deste artigo é estimar a prevalência do tabagismo em mulheres privadas de liberdade e os fatores associados. Estudo de corte transversal, com 259 participantes que responderam um questionário numa prisão no Centro-Oeste do Brasil. A variável dependente foi o tabagismo, e as independentes, as sociodemográficas, histórico de vida, situação jurídica e uso de outras drogas. Realizou-se análises descritiva e bivariada, através de razões de prevalência com o teste Qui-quadrado e, na análise multivariável, a regressão de Poisson. A prevalência de tabagismo foi de 86,87%. No modelo final as variáveis: faixa etária, de 18 a 39 anos (RP 1,33; IC95% 1,10-1,61); uso de álcool (RP 1,26; IC95% 1,00-1,59); uso de maconha (RP 1,16; IC95% 1,03-1,30); e interação entre tempo de prisão e uso de cocaína (RP 1,05; IC95% 1,00-1,11) se mantiveram associadas ao tabagismo. A prevalência de tabagismo foi alta. A faixa etária 18-39 anos, uso de álcool, maconha e interação entre tempo de prisão por 36 meses ou mais e uso de cocaína foram fatores associados ao tabagismo.
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Ives K, Christiansen B, Nolan M, Kaye JT, Fiore MC. Nine years of smoking data from incarcerated men: A call to action for tobacco dependence interventions. Prev Med Rep 2022; 29:101921. [PMID: 35911575 PMCID: PMC9326308 DOI: 10.1016/j.pmedr.2022.101921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
Nearly all people in prison return to smoking shortly after release. Smoking prevalence prior to prison remains very high and is not changing. Most prison survey respondents do not consider themselves addicted. Prison survey respondents have become less interested in help to stay tobacco free. Survey results suggest possible elements for tobacco interventions.
People who are incarcerated use tobacco in high numbers before incarceration and the vast majority resume tobacco use soon after release despite institutional smoking bans. Nine years of surveys collected at a correctional facility in the Midwest, U.S., were analyzed to identify the needs of this high-risk population and suggest future directions for research and intervention development. For the most part, survey respondents considered themselves no longer addicted to tobacco and intended to remain tobacco free after release. They increasingly expected support to remain tobacco free from their home environment despite no change in home tobacco use. Over this nine-year period, significantly fewer respondents wanted materials and help to remain tobacco free, suggesting they have become more challenging to assist. Implications for intervention development and future research are discussed.
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Affiliation(s)
- Kari Ives
- Wisconsin Department of Corrections, 3099 East Washington Ave, Madison, WI 53704, USA
| | - Bruce Christiansen
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St Suite 200, Madison, WI 53711, USA
| | - Margaret Nolan
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St Suite 200, Madison, WI 53711, USA
| | - Jesse T Kaye
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St Suite 200, Madison, WI 53711, USA
| | - Michael C Fiore
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St Suite 200, Madison, WI 53711, USA
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15
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Sourry RJ, Hyslop F, Butler TG, Richmond RL. Impact of smoking bans and other smoking cessation interventions in prisons, mental health and substance use treatment settings: A systematic review of the evidence. Drug Alcohol Rev 2022; 41:1528-1542. [PMID: 36097413 DOI: 10.1111/dar.13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
ISSUES We conducted a systematic review to examine whether smoking bans alone are effective in achieving smoking cessation in people released from prison, and patients discharged from mental health or substance use settings. APPROACH We searched health, criminology and social science databases. Detailed search strings were used to combine terms related to smoking bans and cessation interventions in prison, mental health and substance use treatment settings. We used backward and forward snowballing and manual hand searching to find additional studies. Studies were included if they: were published between 1 January 2000 and 25 February 2022; included a complete smoking ban; measured people released from prison and/or mental health and/or substance use patients smoking post-release/discharge from a smoke-free facility; and reported smoking cessation intervention and/or smoking ban outcomes. Methodological quality was assessed using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies and reviewed by two authors. KEY FINDINGS People released from prison, mental health and substance use in-patients who experience a smoking ban while incarcerated or in in-patient settings often relapse to smoking shortly after release or discharge. We found that although smoking bans alone do not promote cessation, multi-component interventions in combination with smoking bans can significantly increase cessation rates post-release/discharge provided they support participants during this time. CONCLUSIONS There is limited evidence to suggest tobacco bans alone in prison, mental health and substance use treatment settings are effective in achieving long-term smoking cessation. This review suggests that combining smoking bans and cessation interventions including pre- and post-release/discharge support can be effective in achieving smoking cessation.
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Affiliation(s)
| | - Fran Hyslop
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Tony G Butler
- School of Population Health, UNSW Sydney, Sydney, Australia
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16
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Perrett SE, Craddock C, Dunseath G, Shankar G, Luzio S, Gray BJ. Evaluating the impact of a prison smoking ban on the cardiovascular health of men in a UK prison. Int J Prison Health 2022; 19:340-349. [PMID: 35687323 DOI: 10.1108/ijph-02-2022-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Smoking rates are known to be higher amongst those committed to prison than the general population. Those in prison suffer from high rates of comorbidities that are likely to increase their risk of cardiovascular disease (CVD), making it more difficult to manage. In 2016, a tobacco ban began to be implemented across prisons in England and Wales, UK. This study aims to measure the effect of the tobacco ban on predicted cardiovascular risk for those quitting smoking on admission to prison. DESIGN/METHODOLOGY/APPROACH Using data from a prevalence study of CVD in prisons, the authors have assessed the effect of the tobacco ban on cardiovascular risk, using predicted age to CVD event, ten-year CVD risk and heart age, for those who previously smoked and gave up on admission to prison. FINDINGS The results demonstrate measurable health gains across all age groups with the greatest gains found in those aged 50 years and older and who had been heavy smokers. Quitting smoking on admission to prison led to a reduced heart age of between two and seven years for all participants. ORIGINALITY/VALUE The data supports tobacco bans in prisons as a public health measure to reduce risk of CVD. Interventions are needed to encourage maintenance of smoking cessation on release from prison for the full health benefits to be realised.
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Affiliation(s)
| | | | - Gareth Dunseath
- Diabetes Research Group Swansea, Swansea University, Swansea, UK
| | - Giri Shankar
- Department of Health Protection, Public Health Wales, Cardiff, UK
| | - Stephen Luzio
- Diabetes Research Group Swansea, Swansea University, Swansea, UK
| | - Benjamin J Gray
- Research and Evaluation Division, Public Health Wales, Cardiff, UK
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17
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Alokan DS, Kabir Z. Tobacco Use Among People Incarcerated in Western Europe: A Systematic Review and Meta-analysis. Tob Use Insights 2022; 15:1179173X221096641. [PMID: 35600560 PMCID: PMC9118908 DOI: 10.1177/1179173x221096641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 04/06/2022] [Indexed: 12/04/2022] Open
Abstract
Background Evidence suggests that the prevalence of tobacco use has declined significantly in the general population but still remains high among people incarcerated in high-income countries. Tobacco use is the second leading risk factor of mortality and morbidity worldwide. The objective of this study is to synthesize evidence on the prevalence of smoking among people incarcerated in Western European countries. Methods We searched the PubMed database for articles published between June 2010 and June 2020, website of international organizations and hand-searching references. One author reviewed studies that met pre-defined inclusion criteria, and this was cross-validated by a second reviewer, following the MOOSE guidelines. The Meta prop command of Stata (V16) was used for pooling smoking prevalence estimates. Random effects modelling, heterogeneity with subgroup analysis and publication bias was assessed. Results Out the 236 identified articles, 25 with full texts were eligible, and 16 were finally included in this study. The overall pooled estimate of smoking prevalence was 72.3%, 95% CI (54.8–84.7), and high heterogeneity (I2 = 99.73%). Females had a pooled prevalence 44.1% (95% CI 9.4–82.6) while males 83.3% (95% CI 72.0–92.1). The total number of prisoners combined in this study was 16,435 (ranging from 31-21,451) with age ranging from 24-43 years. Conclusion A relatively high smoking rate was observed among incarcerated people - higher among the male population. The study findings are useful for informing policy-makers of the existing burden of smoking in special vulnerable populations across Western Europe-and the need for comprehensive tobacco control policies in different population settings.
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Affiliation(s)
| | - Zubair Kabir
- School of Public Health, University College Cork, Cork, Ireland
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18
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Hunt K, Brown A, Eadie D, McMeekin N, Boyd K, Bauld L, Conaglen P, Craig P, Demou E, Leyland A, Pell J, Purves R, Tweed E, Byrne T, Dobson R, Graham L, Mitchell D, O’Donnell R, Sweeting H, Semple S. Process and impact of implementing a smoke-free policy in prisons in Scotland: TIPs mixed-methods study. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/wglf1204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background
Prisons had partial exemption from the UK’s 2006/7 smoking bans in enclosed public spaces. They became one of the few workplaces with continuing exposure to second-hand smoke, given the high levels of smoking among people in custody. Despite the introduction of smoke-free prisons elsewhere, evaluations of such ‘bans’ have been very limited to date.
Objective
The objective was to provide evidence on the process and impact of implementing a smoke-free policy across a national prison service.
Design
The Tobacco in Prisons study was a three-phase, multimethod study exploring the periods before policy formulation (phase 1: pre announcement), during preparation for implementation (phase 2: preparatory) and after implementation (phase 3: post implementation).
Setting
The study was set in Scotland’s prisons.
Participants
Participants were people in custody, prison staff and providers/users of prison smoking cessation services.
Intervention
Comprehensive smoke-free prison rules were implemented across all of Scotland’s prisons in November 2018.
Main outcome measures
The main outcome measures were second-hand smoke levels, health outcomes and perspectives/experiences, including facilitators of successful transitions to smoke-free prisons.
Data sources
The study utilised cross-sectional surveys of staff (total, n = 3522) and people in custody (total, n = 5956) in each phase; focus groups and/or one-to-one interviews with staff (n = 237 across 34 focus groups; n = 38 interviews), people in custody (n = 62 interviews), providers (n = 103 interviews) and users (n = 45 interviews) of prison smoking cessation services and stakeholders elsewhere (n = 19); measurements of second-hand smoke exposure (e.g. 369,208 minutes of static measures in residential areas at three time points); and routinely collected data (e.g. medications dispensed, inpatient/outpatient visits).
Results
Measures of second-hand smoke were substantially (≈ 90%) reduced post implementation, compared with baseline, largely confirming the views of staff and people in custody that illicit smoking is not a major issue post ban. Several factors that contributed to the successful implementation of the smoke-free policy, now accepted as the ‘new normal’, were identified. E-cigarette use has become common, was recognised (by both staff and people in custody) to have facilitated the transition and raises new issues in prisons. The health economic analysis (lifetime model) demonstrated that costs were lower and the number of quality-adjusted life-years was larger for people in custody and staff in the ‘with smoke-free’ policy period than in the ‘without’ policy period, confirming cost-effectiveness against a £20,000 willingness-to-pay threshold.
Limitations
The ability to triangulate between different data sources mitigated limitations with constituent data sets.
Conclusions
To our knowledge, this is the first study internationally to analyse the views of prison staff and people in custody; objective measurements of second-hand smoke exposure and routine health and other outcomes before, during and after the implementation of a smoke-free prison policy; and to assess cost-effectiveness. The results are relevant to jurisdictions considering similar legislation, whether or not e-cigarettes are permitted. The study provides a model for partnership working and, as a multidimensional study of a national prison system, adds to a previously sparse evidence base internationally.
Future work
Priorities are to understand how to support people in custody in remaining smoke free after release from prison, and whether or not interventions can extend benefits to their families; to evaluate new guidance supporting people wishing to reduce or quit vaping; and to understand how prison vaping practices/cultures may strengthen or weaken long-term reductions in smoking.
Study registration
This study is registered as Research Registry 4802.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 1. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Ashley Brown
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Douglas Eadie
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Nicola McMeekin
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kathleen Boyd
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Linda Bauld
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Philip Conaglen
- Department of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alastair Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jill Pell
- Institute for Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Richard Purves
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Emily Tweed
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Tom Byrne
- Public Health Scotland, Edinburgh, UK
| | - Ruaraidh Dobson
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | | | - Danielle Mitchell
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Rachel O’Donnell
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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19
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Hawes ES, Mildrum Chana S, Faust A, Baker JC, Hendricks PS, Azuero A, Lahti AC, Carpenter MJ, Cropsey KL. In vivo Experience With NRT to Increase Adherence and Smoking Abstinence Among Individuals in the Criminal Legal System: Study Protocol for a Randomized Clinical Trial. Front Psychiatry 2022; 13:886680. [PMID: 35800020 PMCID: PMC9253399 DOI: 10.3389/fpsyt.2022.886680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/26/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND While tobacco use among individuals involved in the criminal legal system remains 3-4 times higher than the general population, few interventions have been targeted for this population to aid in smoking cessation. Nicotine replacement therapy (NRT) is a relatively effective and accessible smoking cessation aid; however, individuals frequently stop use of NRT early due to side effects and misperceptions about the products. The present study aims to address low medication adherence by examining the efficacy of an "in vivo" NRT sampling experience in individuals under community criminal legal supervision. METHODS Following recruitment through community legal outlets, participants (N = 517) are randomized to either an "in vivo NRT sampling" group or a standard smoking cessation behavioral counseling group. The in vivo group uses NRT in session and discusses perceptions and experiences of using NRT in real time while the standard smoking cessation counseling group receives four sessions of standard behavioral smoking cessation counseling. Both groups receive four intervention sessions and 12 weeks of NRT following the intervention. The 6-month post-intervention primary outcome measures are smoking point-prevalence abstinence and medication adherence. CONCLUSION This is a novel smoking cessation intervention specifically aimed at increasing NRT adherence and smoking cessation among those involved in the criminal legal system, a group of individuals with high smoking rates and low rates of pharmacotherapy use. If proven effective, the present treatment could be a novel intervention to implement in criminal legal settings given the minimal requirement of resources and training.This trial is registered with www.clinicaltrials.gov-NCT02938403.
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Affiliation(s)
- Elizabeth S Hawes
- Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sofía Mildrum Chana
- Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Alexandra Faust
- Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Julianne C Baker
- Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Andres Azuero
- Department of Nursing, Family, Community and Health Systems, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Karen L Cropsey
- Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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20
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[Suicides in the German prison system: frequency, risk factors, and prevention]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 65:18-24. [PMID: 34964913 PMCID: PMC8732920 DOI: 10.1007/s00103-021-03460-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/08/2021] [Indexed: 11/19/2022]
Abstract
Gefangene haben ein hohes Suizidrisiko und die höchsten Suizidraten sind bei Untersuchungsgefangenen zu verzeichnen. Suizid ist die häufigste singuläre Todesursache in deutschen Gefängnissen. In diesem narrativen Übersichtsbeitrag werden zunächst die Gefängnispopulation und ihre allgemeine Gesundheitsversorgung beschrieben, wobei insbesondere auf psychiatrische und Substanzkonsumstörungen eingegangen wird. Der Hauptteil widmet sich der Prävalenz, den Ursachen und Risikofaktoren von Gefängnissuizid. Maßnahmen zur Suizidprävention werden dargestellt. Der Anteil von Männern unter Gefangenen in Deutschland ist mit 94 % (2020) wie in allen Teilen der Welt sehr hoch. Die meisten Gefangenen sind jungen oder mittleren Alters. Die durchschnittlichen jährlichen Suizidraten bei Männern und Frauen in deutschen Gefängnissen entsprechen mit 105,8/100.000 bzw. 54,7/100.000 denen der meisten Länder in der Europäischen Union (Vollerhebung 2000–2011). Die Suizidraten bei männlichen deutschen Gefangenen sind in den Jahren 2000–2013 unabhängig vom Alter kontinuierlich zurückgegangen. Bei weiblichen Gefangenen stiegen sie dagegen an, wobei die Ursachen hierfür nicht bekannt sind. Es gibt Hinweise darauf, dass psychiatrische Erkrankungen nicht erkannt worden waren. Wichtige suizidpräventive Maßnahmen sind die Unterbringung in Gemeinschaft und die Vermeidung von Isolation, beispielsweise durch das Angebot von Arbeit. Zudem stehen validierte deutschsprachige Screeninginstrumente zur Verfügung, um ein Suizidrisiko frühzeitig zu erkennen. Für eine wirksame Gefängnissuizidprävention bedarf es der Identifikation von Hochrisikopersonen, des Angebots geeigneter suizidpräventiver Maßnahmen sowie der Entwicklung teambezogener Maßnahmen beim Gefängnispersonal.
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21
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Mohammadnezhad M, Kengganpanich M. Factors affecting smoking initiation and cessation among adult smokers in Fiji: A qualitative study. Tob Induc Dis 2021; 19:92. [PMID: 34949974 PMCID: PMC8647017 DOI: 10.18332/tid/143027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Smoking as a public health challenge is globally considered the main risk factor of many non-communicable diseases (NCDs). Knowing factors contributing to smoking commencement and cessation is the necessary step to develop prevention strategies to combat this issue. To date, no study has been conducted in Fiji, therefore this study aimed to explore the reasons adult smokers initiate smoking and cessation in Fiji. METHODS A qualitative study was conducted among 35 current smokers who were interviewed between 1 May and 31 July 2020 in Suva, Fiji. Three health centers were chosen randomly to collect data and purposive sampling was applied to reach study participants. A semi-structured, open-ended questionnaire was used to guide the interviews. The content of in-depth interviews was transcribed and data were analyzed using content and thematic analysis. RESULTS The results of this study showed that most of the participants were male (57%), I-taukei (77%), single (54%), had attained tertiary education level (69%), were of Christian religion (77%), and unemployed (63%). Two main themes were identified including: ‘factors affecting smoking initiation’ and ‘factors affecting smoking cessation’. ‘Peer pressure’, ‘smoking myth’, ‘smoking as a fun’, ‘unpleasant event in life’ and ‘smoking establishes friendships’ were factors affecting initiation of smoking; while ‘knowledge on smoking harms’, ‘financial constraints’, ‘desire to improve health’, ‘constant request from family members’, ‘desire to save time’, ‘religious factors’ and ‘cultural factors’, were factors affecting smoking cessation among smokers. CONCLUSIONS This study highlights the main factors affecting smoking among adult smokers in Fiji. Considering these factors in future health planning will help policy makers and decision makers to develop tailored interventions to combat this health issue.
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Affiliation(s)
| | - Mondha Kengganpanich
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
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22
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Albany H, Richmond R, Simpson M, Kariminia A, Hwang YIJ, Butler T. Smoking Beyond Prison Bans: The Impact of Prison Tobacco Bans on Smoking Among Prison Entrants. JOURNAL OF CORRECTIONAL HEALTH CARE 2021; 27:280-288. [PMID: 34735264 DOI: 10.1089/jchc.19.08.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study aims to determine whether previous exposure to a total prison smoking ban is associated with a reduction in daily smoking postrelease and to identify the factors associated with daily tobacco use. Demographics, incarceration history, and substance use data were collected from the 2016 National Prisoner Entrants' Blood Borne Virus Survey for 389 Australian prison entrants. Predictors of daily smoking among those exposed to a smoking ban were illicit drug use and Indigenous status. No significant association was found between current daily smoking and recent exposure to a prison smoking ban, suggesting that the majority of Australian prisoners exposed to a tobacco ban while incarcerated will return to smoking once released. Complementary and culturally specific interventions supporting abstinence postrelease should be considered.
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Affiliation(s)
- Hamish Albany
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Robyn Richmond
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Melanie Simpson
- Department of Communities and Justice, Youth Justice NSW, Sydney, New South Wales, Australia
| | - Azar Kariminia
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Ye In Jane Hwang
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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23
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Jin X, Kinner SA, Hopkins R, Stockings E, Courtney RJ, Shakeshaft A, Petrie D, Dobbins T, Puljevic C, Chang S, Dolan K. A randomised controlled trial of motivational interview for relapse prevention after release from smoke-free prisons in Australia. Int J Prison Health 2021. [DOI: 10.1108/ijph-01-2020-0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons.
Design/methodology/approach
This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45–60 min) face-to-face MI intervention 4–6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release.
Findings
From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01).
Research limitations/implications
A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention.
Originality/value
This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.
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Bowe A, Marron L, Devlin J, Kavanagh P. An Evaluation of the Impact of a Multicomponent Stop Smoking Intervention in an Irish Prison. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211981. [PMID: 34831737 PMCID: PMC8624287 DOI: 10.3390/ijerph182211981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 11/29/2022]
Abstract
The disproportionately high prevalence of tobacco use among prisoners remains an important public health issue. While Ireland has well-established legislative bans on smoking in public places, these do not apply in prisons. This study evaluates a multi-component tobacco control intervention in a medium security prison for adult males in Ireland. A stop-smoking intervention, targeting staff and prisoners, was designed, implemented, and evaluated with a before-and-after study. Analysis was conducted using McNemar’s test for paired binary data, Wilcoxon signed rank test for ordinal data, and paired T-tests for continuous normal data. Pre-intervention, 44.3% (n = 58) of the study population were current smokers, consisting of 60.7% of prisoners (n = 51) and 15.9% of staff (n = 7). Post-intervention, 45.1% of prisoners (n = 23/51) and 100% of staff (n = 7/7) who identified as current smokers pre-intervention reported abstinence from smoking. Among non-smokers, the proportion reporting being exposed to someone else’s cigarette smoke while being a resident or working in the unit decreased from 69.4% (n = 50/72) pre-intervention to 27.8% (n = 20/72) post-intervention (p < 0.001). This multicomponent intervention resulted in high abstinence rates, had high acceptability among both staff and prisoners, and was associated with wider health benefits across the prison setting.
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Affiliation(s)
- Andrea Bowe
- Health Intelligence Unit, Strategic Planning and Transformation, Health Service Executive, Dublin, Ireland;
- Correspondence:
| | - Louise Marron
- Department of Public Health, Health Service Executive, Dr. Steevens’ Hospital, Dublin, Ireland;
| | - John Devlin
- Irish Prison Service Irish, IDA Business Park, Ballinalee Road, Longford, Ireland;
| | - Paul Kavanagh
- Health Intelligence Unit, Strategic Planning and Transformation, Health Service Executive, Dublin, Ireland;
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Smoking bans in prisons. THE LANCET PUBLIC HEALTH 2021; 6:e781-e782. [DOI: 10.1016/s2468-2667(21)00182-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022] Open
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Tweed EJ, Mackay DF, Boyd KA, Brown A, Byrne T, Conaglen P, Craig P, Demou E, Graham L, Leyland AH, McMeekin N, Pell JP, Sweeting H, Hunt K. Evaluation of a national smoke-free prisons policy using medication dispensing: an interrupted time-series analysis. Lancet Public Health 2021; 6:e795-e804. [PMID: 34537108 PMCID: PMC8554387 DOI: 10.1016/s2468-2667(21)00163-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Internationally, smoking prevalence among people in prison custody (ie, people on remand awaiting trial, awaiting sentencing, or serving a custodial sentence) is high. In Scotland, all prisons implemented a comprehensive smoke-free policy in 2018 after a 16-month anticipatory period. In this study, we aimed to use data on medication dispensing to assess the impact of this policy on cessation support, health outcomes, and potential unintended consequences among people in prison custody. METHODS We did an interrupted time-series analysis using dispensing data for 44 660 individuals incarcerated in 14 closed prisons in Scotland between March 30, 2014, and Nov 30, 2019. We estimated changes in dispensing rates associated with the policy announcement (July 17, 2017) and full implementation (Nov 30, 2018) using seasonal autoregressive integrated moving average models. Medication categories of primary interest were treatments for nicotine dependence (as an indicator of smoking cessation or abstinence attempts), acute smoking-associated illnesses, and mental health (antidepressants). We included antiepileptic medications as a negative control. FINDINGS A 44% step increase in dispensing of treatments for nicotine dependence was observed at implementation (2250 items per 1000 people in custody per fortnight, 95% CI 1875 to 2624) due primarily to a 42% increase in dispensing of nicotine replacement therapy (2109 items per 1000 people in custody per fortnight, 1701 to 2516). A 9% step decrease in dispensing for smoking-related illnesses was observed at implementation, largely accounted for by respiratory medications (-646 items per 1000 people in custody per fortnight, -1111 to -181). No changes associated with announcement or implementation were observed for mental health dispensing or antiepileptic medications (control). INTERPRETATION Smoke-free prison policies might improve respiratory health among people in custody and encourage smoking abstinence or cessation without apparent short-term adverse effects on mental health dispensing. FUNDING National Institute of Health Research Public Health Research programme, Scottish Government Chief Scientist Office, and UK Medical Research Council.
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Affiliation(s)
- Emily J Tweed
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Daniel F Mackay
- Department of Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kathleen A Boyd
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ashley Brown
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Thomas Byrne
- NHS Healthcare Improvement Scotland, Glasgow, UK
| | - Philip Conaglen
- Department of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
| | - Peter Craig
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Evangelia Demou
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Alastair H Leyland
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nicola McMeekin
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Department of Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Helen Sweeting
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- Department of Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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Sweeting H, Demou E, Brown A, Hunt K. Prisoners and prison staff express increased support for prison smoking bans following implementation across Scotland: results from the Tobacco In Prisons study. Tob Control 2021; 30:597-598. [PMID: 32587111 DOI: 10.1136/tobaccocontrol-2020-055683] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/27/2020] [Accepted: 05/12/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Helen Sweeting
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Evangelia Demou
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ashley Brown
- Institute of Social Marketing, University of Stirling, Stirling, UK
| | - Kate Hunt
- Institute of Social Marketing, University of Stirling, Stirling, UK
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Mental and Physical Health Problems as Conditions of Ex-Prisoner Re-Entry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147642. [PMID: 34300093 PMCID: PMC8306707 DOI: 10.3390/ijerph18147642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/01/2021] [Accepted: 07/11/2021] [Indexed: 11/16/2022]
Abstract
The article focuses on a less-discussed issue of social marginalization of people leaving penitentiaries, which is the prevalence of multifaceted health problems experienced by people in this category. It includes poor health status, resulting from, among others, poor housing conditions, harmful or risky lifestyle, and lack of access to medical services. Data from the District Inspectorate of the Prison Service in Lodz, Poland on the health conditions of inmates was accessed. These data were supplemented by qualitative research conducted in 21 juvenile detention centers and 8 prisons across the country, conducting direct observations and In-Depth Interviews (IDI). A total of 198 IDIs were conducted with incarcerated (72) and released (30) juvenile offenders, and incarcerated (68) and released (28) adult offenders. These were complemented by IDIs with experts (50) and Focus Group Interviews (FGIs; 8) with male and female inmates in 4 Polish prisons. The study revealed that mental and physical health is a serious obstacle to social reintegration of ex-prisoners. It is rarely addressed by state institutions. There are strong associations between neglect of health issues in the prison population and increasing social exclusion after leaving prison. As Poland has a restrictive penal policy, former prisoners remain a group with social stigma and little support.
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Lins-Filho PC, Carvalho FMTD, Freitas JLDM, Ferreira AKA, Melo MCFD, Godoy GP, Caldas Jr ADF. Drug use pattern among non-heterosexual and transgender people detained in a female prison complex. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1916850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | | | | | - Gustavo Pina Godoy
- Post Graduation Programme in Dentistry, Federal University of Pernambuco, Recife, Brazil
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Brown A, O’Donnell R, Eadie D, Purves R, Sweeting H, Ford A, Bauld L, Hunt K. Initial Views and Experiences of Vaping in Prisons: A Qualitative Study With People in Custody Preparing for the Imminent Implementation of Scotland's Prison Smokefree Policy. Nicotine Tob Res 2021; 23:543-549. [PMID: 32447381 PMCID: PMC7885768 DOI: 10.1093/ntr/ntaa088] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/21/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Scotland is one of the few countries in which e-cigarettes were available in prisons before the introduction of a comprehensive national smokefree policy, to assist in its implementation. This qualitative study explores the initial views and experiences of vaping in this specific context, from the perspective of people in custody (prisoners). AIMS AND METHODS Twenty-eight people in custody were interviewed approximately 1-2 months after rechargeable e-cigarettes were made available in prisons and 2-5 weeks before implementation of a smokefree policy. Data were thematically analyzed to identify the range and diversity of views and experiences. RESULTS Participants expressed support for e-cigarettes in preparation for the smokefree policy, describing their symbolic and practical value in this context. Uptake of vaping was strongly influenced by the need for participants to manage without tobacco in the near future. Participants evaluated their initial vaping experiences, either positively or negatively, in relation to the utility of e-cigarettes for mandated smoking abstinence and in providing satisfaction, pleasure, and novelty. Participant views on several issues related to e-cigarette use, both specific to the prison population (product choice and cost) and more generally (safety and long-term use), are explored. CONCLUSIONS Our findings suggest possible benefits of e-cigarettes as one means of supporting smokefree policy in a population with many smokers. They also point to potential challenges posed by vaping in prisons and smokefree settings caring for similar populations. There is a need for ongoing measures to maximize the health benefits of smokefree settings and for further research on vaping in situations of enforced abstinence. IMPLICATIONS To our knowledge, no published studies have explored views and experiences of vaping in prison, when rechargeable vapes were new and the removal of tobacco was imminent. The results can inform tobacco control policy choices, planning and implementation in prisons and similar settings. In prison systems that permitting vaping, it is important that other measures (eg, information campaigns and nicotine dependence services) are implemented concurrently to minimize potential risks to the health or personal finances of people in custody.
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Affiliation(s)
- Ashley Brown
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Rachel O’Donnell
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Douglas Eadie
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Richard Purves
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Allison Ford
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Linda Bauld
- Usher Institute and SPECTRUM Consortium, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Kate Hunt
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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Johnson C, Bien-Aimé I, Dubois L. Weight gain and chronic disease progression among individuals incarcerated in Canadian federal penitentiaries: a retrospective cohort study. Int J Prison Health 2020. [DOI: 10.1108/ijph-05-2020-0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Very little is known about how weight gain during incarceration influences the health of people living in Canadian federal penitentiaries. To fill this knowledge gap, this study aims to determine how the observed weight gain influenced the development of obesity-related chronic diseases during incarceration.
Design/methodology/approach
This retrospective cohort study examined the association between weight gain and obesity-related chronic diseases for 1,420 participants incarcerated in federal penitentiaries in Ontario, New Brunswick and Nova Scotia. To participate, individuals had to be incarcerated for at least six months at the time of the study (2016–2017). Current anthropometric data were measured or taken from medical records, then compared to anthropometric data at the beginning of incarceration (mean follow-up of 5.0 years) to determine weight change (kg) and body mass index change (kg/m2) during incarceration. Then, information about obesity-related chronic diseases was drawn from the participants’ medical records.
Findings
Chi-square and nonparametric median comparison tests were performed to detect statistically significant changes in anthropometric data, to determine if a relationship was present. This study observed a significant association between weight gain and disease development for many types of obesity-related chronic diseases (e.g. cancer, type 2 diabetes, hypertension, dyslipidemia and sleep apnea). This confirmed an association between weight gain and chronic disease development in the prison population.
Originality/value
Participants who gained a significant amount of weight, during incarceration, were also more frequently diagnosed with obesity-related chronic diseases. These findings suggest that weight gain may contribute to the deterioration of peoples’ health during incarceration.
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Jodalli P, Panchmal GS. Tobacco use patterns and predictors among college students in Mangalore, South India: Findings from the Global Adult Tobacco Survey. Tob Prev Cessat 2020; 6:58. [PMID: 33163704 PMCID: PMC7643585 DOI: 10.18332/tpc/127375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Praveen Jodalli
- Department of Public Health Dentistry, Yenepoya Dental College, Yenepoya (Deemed to be University), Mangalore, India
| | - Ganesh S. Panchmal
- Department of Public Health Dentistry, Yenepoya Dental College, Yenepoya (Deemed to be University), Mangalore, India
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Bondolfi C, Taffe P, Augsburger A, Jaques C, Malebranche M, Clair C, Bodenmann P. Impact of incarceration on cardiovascular disease risk factors: a systematic review and meta-regression on weight and BMI change. BMJ Open 2020; 10:e039278. [PMID: 33067292 PMCID: PMC7569938 DOI: 10.1136/bmjopen-2020-039278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Cardiovascular disease is an underappreciated issue in prison medicine. Recent studies have revealed a higher prevalence of cardiovascular disease risk factors (CVDRFs) among individuals in prison, but the impact of incarceration on CVDRFs over time is not well understood. This review aimed to assess available literature and quantify the relationship between incarceration and trends in major CVDRFs in high-income countries. DESIGN Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-regression on weight change and obesity. DATA SOURCES Medline, Embase, PubMed, Cochrane Central Wiley and Web of Science. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Longitudinal studies reporting on the incidence of, or trends in any CVDRF among current or former people in prison over time, in high-income countries. DATA EXTRACTION AND SYNTHESIS Two authors independently screened articles for eligibility, extracted data and assessed quality using an adapted version of the Newcastle-Ottawa Scale. Trends in CVDRFs during and following incarceration were summarised and in those with sufficient data a meta-regression was performed. RESULTS Twenty-six articles were identified. CVDRFs assessed included obesity, hypertension, diabetes, dyslipidaemia, tobacco use, physical inactivity and unhealthy diet. A meta-regression on change in weight during incarceration found a mean increase of 5.3 kg (95% CI 0.5 to 10.1) and change in body mass index of 1.8 kg/m2 (95% CI -0.9 to 4.6) at 2 years. Weight gain appeared most pronounced right after entering prison and then plateaued at 2 years. Concerning hypertension, the results were inconclusive, despite a trend towards rising blood pressure or prevalence of hypertension during incarceration, and an increased incidence of hypertension following incarceration. Results are contradictory or inconclusive for the other CVDRFs reviewed. CONCLUSION Possible explanations for the association between incarceration and weight include a sedentary lifestyle, unhealthy diet, forced smoking cessation, psychotropic medication use and high levels of stress. Incarceration may be an independent risk factor for cardiovascular disease.
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Affiliation(s)
- Constantin Bondolfi
- Department of Vulnerable Populations and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, Switzerland
| | - Patrick Taffe
- Division of Biostatistics, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, Switzerland
| | - Aurélie Augsburger
- Department of Ambulatory Care and Community Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, Switzerland
| | | | - Mary Malebranche
- Department of Vulnerable Populations and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, Switzerland
- Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Carole Clair
- Department of Ambulatory Care and Community Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, Switzerland
| | - Patrick Bodenmann
- Department of Vulnerable Populations and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, Switzerland
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Ako T, Plugge E, Mhlanga-Gunda R, Van Hout MC. Ethical guidance for health research in prisons in low- and middle-income countries: a scoping review. Public Health 2020; 186:217-227. [PMID: 32861921 PMCID: PMC7449980 DOI: 10.1016/j.puhe.2020.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study examined the extent, range and nature of the published literature, prison policies and technical guidance relating to the ethical conduct of health research in prisons in low- and middle-income countries (LMICs). STUDY DESIGN Scoping Review. METHODS We adhered to the five stages of the scoping review iterative process: identifying the research question, identifying relevant studies, study selection, charting the data, and collating, summarizing and content analysis of polices. Disagreements around allocation of content were resolved through team discussion. We also appraised the quality of the included articles. RESULTS We included nine records that examined the ethical aspects of the conduct of health research in prisons in LMICs; eight of these were peer-reviewed publications, and one was a toolkit. Despite the unique vulnerabilities of this group, we could find no comprehensive guidelines on the ethical conduct of health research in prisons in LMICs. CONCLUSIONS The majority of the world's imprisoned populations are in LMICs, and they have considerable health needs. Research plays an important role in addressing these needs and in so doing, will contribute to the achievement of the Sustainable Development Goals. With regards to health research, imprisoned people in LMICs are 'left behind'; there is a lack of clear, prison-focused guidance and oversight to ensure high quality ethical health research so necessary in LMICs. There is an urgent need for prison health experts to work with health research ethics experts and custodial practitioners for procedural issues in the development of prison-specific ethical guidance for health research in LMICs aligned with international standards.
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Affiliation(s)
- T Ako
- Chief Medical Office, Cameroon Penitentiary Services, Cameroon.
| | - E Plugge
- UK Collaborating Centre for the WHO (Europe) Health in Prisons Programme, Health and Justice, ADT-J Division, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, England, United Kingdom.
| | - R Mhlanga-Gunda
- College of Health Sciences, Centre for Evaluation of Public Health Interventions, Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
| | - M C Van Hout
- Public Health Institute, Liverpool John Moore's University, Liverpool, L32ET, United Kingdom.
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Brown A, Eadie D, Purves R, Mohan A, Hunt K. Perspectives on smokefree prison policy among people in custody in Scotland. Int J Prison Health 2020; 16:389-402. [PMID: 33634669 PMCID: PMC7810021 DOI: 10.1108/ijph-12-2019-0065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose This paper aims to explore smokefree prison policy, from the perspective of people in custody in Scotland. Design/methodology/approach In total, 77 people in custody in Scotland were interviewed in the period leading up to implementation of a nationwide prison smokefree policy. Data were thematically analysed to identify the diversity of views and experiences. Findings Participants described a widespread awareness in prisons of plans to implement a smokefree policy from 30 November 2018. Opinions about smokefree prisons varied among participants based on perceptions of the fairness, and anticipated positive and negative consequences of removing tobacco from prisons. At the time of the interviews, people in custody were responding to the impending smokefree policy, either by proactively preparing for the smokefree rule change or by deploying avoidance strategies. Participants described opportunities and challenges for implementing smokefree policy in prisons across three main themes: the role of smoking in prison, prison smoking cessation services and motivations for quitting smoking among people in custody. Originality/value This study exploring smokefree prisons from the perspectives of people in custody has several novel features which extend the evidence base. The findings highlight measures for jurisdictions to consider when planning to prohibit smoking in their prisons in the future. These include the need for evidence-based smoking cessation support in advance of smokefree policy, effective communication campaigns, consideration of broader structural determinants of health in prison and ongoing measures to reduce rates of return to smoking post release.
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Affiliation(s)
- Ashley Brown
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Douglas Eadie
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Richard Purves
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Andrea Mohan
- School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | - Kate Hunt
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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Valera P, Acuna N, Vento I. The Preliminary Efficacy and Feasibility of Group-Based Smoking Cessation Treatment Program for Incarcerated Smokers. Am J Mens Health 2020; 14:1557988320943357. [PMID: 32705965 PMCID: PMC7383630 DOI: 10.1177/1557988320943357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Group-based tobacco dependence treatment has been known to help smokers to quit in general adult populations, but the feasibility and efficacy of this type of smoking cessation treatment in correctional settings remain uncertain. A 6-week group-based smoking cessation treatment with nicotine replacement therapy (NRT) in the form of nicotine patches was implemented in seven male prison facilities, in the Northeast, among smokers who were born biologically as male. Exhaled breath carbon monoxide (CO) levels were collected from participants at each session to confirm smoking status. Participants were evaluated at the 1-month post-group treatment follow-up to determine abstinence. Those who were lost to follow-up were recorded as continued smoking and not using NRT nicotine patches. The goal of the study was to explore the feasibility and preliminary efficacy of conducting a smoking cessation treatment program for incarcerated smokers. A total of 350 inmates were screened, 177 inmates were enrolled across the prison sites for the 6-week program, and 102 inmates completed the program. A majority of those enrolled reported that they began smoking when they were between 15 and 19 years of age (44.9%) and were smoking on average for 26 years. Less than half (21.3%) reported ever using electronic cigarettes at baseline and in Session 1,116 individuals who attended reported a median CO level of 18.0 parts per million (ppm). At a 1-month follow-up, 43 individuals reported a median CO level of 5.00 ppm. The study demonstrated preliminary efficacy and feasibility of group-based smoking cessation treatment with NRT nicotine patches in incarcerated smokers.
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Affiliation(s)
- Pamela Valera
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
| | - Nicholas Acuna
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
| | - Ismary Vento
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
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Abstract
Incarcerated men in the United States, an understudied population, have not been the focus of cancer prevention research. This pilot study explored the impact of Cancer 101 for imprisoned male smokers to increase cancer knowledge and promote cancer prevention activities in the prison population. Cancer 101 was pilot tested for adoption with representatives from the target audience in three prison facilities located in the northeastern region of the United States, and based on their feedback, modifications were implemented. Pretest and posttest surveys were used to assess knowledge of attitudes regarding the benefits of cancer prevention activities at baseline and immediately after completing Cancer 101. Furthermore, a paired t test procedure was used to determine whether cancer knowledge improved after participating in the Cancer 101 program. A total of 161 men completed all of the modules, participated in pre/post assessments, and qualitatively described their behavioral intentions to participate in activities that could reduce cancer risk. The mean cancer knowledge scores differed before and after completing Cancer 101, t(163) = -14.67, p < .001. Regarding age, the older the respondent, the higher their cancer knowledge score, r = .29, p < .001. This study showed improvements in cancer knowledge scores and behavioral intentions to participate in activities to reduce cancer. Cancer 101 provides opportunities for inmates to increase cancer knowledge, as well as promote action for cancer control during incarceration.
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Affiliation(s)
| | | | - Karen Cropsey
- University of Alabama at Birmingham School of Medicine
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Tong X, Chaudhry Z, Lee CC, Bone RN, Kanojia S, Maddatu J, Sohn P, Weaver SA, Robertson MA, Petrache I, Evans-Molina C, Kono T. Cigarette smoke exposure impairs β-cell function through activation of oxidative stress and ceramide accumulation. Mol Metab 2020; 37:100975. [PMID: 32283079 PMCID: PMC7170997 DOI: 10.1016/j.molmet.2020.100975] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES Epidemiological studies indicate that first- and second-hand cigarette smoke (CS) exposure are important risk factors for the development of type 2 diabetes (T2D). Additionally, elevated diabetes risk has been reported to occur within a short period of time after smoking cessation, and health risks associated with smoking are increased when combined with obesity. At present, the mechanisms underlying these associations remain incompletely understood. The objective of this study was to test the impact of CS exposure on pancreatic β-cell function using rodent and in vitro models. METHODS Beginning at 8 weeks of age, C57BL/6 J mice were concurrently fed a high-fat diet (HFD) and exposed to CS for 11 weeks, followed by an additional 11 weeks of smoking cessation with continued HFD. Glucose tolerance testing was performed during CS exposure and during the cessation period. Cultured INS-1 β-cells and primary islets were exposed ex vivo to CS extract (CSE), and β-cell function and viability were tested. Since CS increases ceramide accumulation in the lung and these bioactive sphingolipids have been implicated in pancreatic β-cell dysfunction in diabetes, islet and β-cell sphingolipid levels were measured in islets from CS-exposed mice and in CSE-treated islets and INS-1 cells using liquid chromatography-tandem mass spectrometry. RESULTS Compared to HFD-fed, ambient air-exposed mice, HFD-fed and CS-exposed mice had reduced weight gain and better glucose tolerance during the active smoking period. Following smoking cessation, CS-mice exhibited rapid weight gain and had accelerated worsening of their glucose tolerance. CS-exposed mice had higher serum proinsulin/insulin ratios, indicative of β-cell dysfunction, significantly lower β-cell mass (p = 0.017), reduced β-cell proliferation (p = 0.006), and increased islet ceramide content compared to non-smoking control mice. Ex vivo exposure of isolated islets to CSE was sufficient to increase islet ceramide levels, which was correlated with reduced insulin gene expression and glucose-stimulated insulin secretion, and increased β-cell oxidative and endoplasmic reticulum (ER) stress. Treatment with the antioxidant N-acetylcysteine markedly attenuated the effects of CSE on ceramide levels, restored β-cell function and survival, and increased cyclin D2 expression, while also reducing activation of β-cell ER and oxidative stress. CONCLUSIONS Our results indicate that CS exposure leads to impaired insulin production, processing, secretion and reduced β-cell viability and proliferation. These effects were linked to increased β-cell oxidative and ER stress and ceramide accumulation. Mice fed HFD continued to experience detrimental effects of CS exposure even during smoking cessation. Elucidation of the mechanisms by which CS exposure impairs β-cell function in synergy with obesity will help design therapeutic and preventive interventions for both active and former smokers.
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Affiliation(s)
- Xin Tong
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Zunaira Chaudhry
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chih-Chun Lee
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert N. Bone
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sukrati Kanojia
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Judith Maddatu
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Paul Sohn
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA,Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Staci A. Weaver
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA,Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Irina Petrache
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, National Jewish Health, Denver, CO, USA,Corresponding author. 1400 Jackson St, Denver, CO, 80806, USA. Tel.: +303 270 2080.
| | - Carmella Evans-Molina
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA,Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA,Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN, USA,Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA,Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA,Corresponding author. Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Tatsuyoshi Kono
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA,Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA,Corresponding author. Indiana University School of Medicine, 635 Barnhill Drive, MS 2031A, Indianapolis, IN, 46202, USA. Tel.: +317 274 4145; fax 317 274 4107.
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Zeng LN, Zong QQ, Zhang JW, An FR, Xiang YF, Ng CH, Ungvari GS, Yang FY, Yan H, Chen LG, Hu X, Xiang YT. Prevalence of smoking in nursing students worldwide: A meta-analysis of observational studies. NURSE EDUCATION TODAY 2020; 84:104205. [PMID: 31734641 DOI: 10.1016/j.nedt.2019.104205] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 06/18/2019] [Accepted: 09/06/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Smoking is common among nursing students worldwide, but the reported prevalence is inconsistent across epidemiological studies. This is a meta-analysis of the prevalence of smoking in nursing students worldwide. DESIGN Meta-analysis of observational studies. SAMPLE A total of 46 studies were included in this meta-analysis. METHOD Electronic databases (PubMed, Medline, PsycINFO, EMBASE and Web of science) were independently and systematically searched by two investigators from their commencement date up to 12 May 2018. Studies that reported the smoking rate of nursing students were included and analyzed using random-effects model. RESULTS The pooled prevalence of current smoking was 26.6% (95% CI: 22.9-30.4%), while pooled prevalence of previous smoking was 15.5% (95% CI: 11.8-19.3%). Subgroup analyses showed that smoking rate was higher in male compared with female students (39% vs 25.2%, P < .001), while survey time, sample size, age, study design and academic year did not moderate the smoking rate (all P > .05). CONCLUSION This meta-analysis confirmed that smoking is common in nursing students. Considering the negative impact of smoking on health, appropriate smoking cessation measures for nursing students should be developed.
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Affiliation(s)
- Liang-Nan Zeng
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau; Center for Cognition and Brain Sciences, University of Macau, Macau; Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University; Neurosurgery Clinical Medical Research Center of Sichuan Province, Academician (Expert) Workstation of Sichuan Province; Sichuan, China
| | - Qian-Qian Zong
- School of Nursing, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Ji-Wen Zhang
- School of Nursing, Capital Medical University, Beijing, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | | | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Gabor S Ungvari
- The University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Fang-Yu Yang
- School of Nursing, Capital Medical University, Beijing, China
| | - Hong Yan
- School of Public Health, Wuhan University, Wuhan, China
| | - Li-Gang Chen
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University; Neurosurgery Clinical Medical Research Center of Sichuan Province, Academician (Expert) Workstation of Sichuan Province; Sichuan, China.
| | - Xiaobin Hu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau; Center for Cognition and Brain Sciences, University of Macau, Macau.
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Awooda EM, Shashati DE. Tobacco use among male inmates and their attitudes toward its prevention in Khartoum State: A cross-sectional study. Tob Prev Cessat 2019; 5:25. [PMID: 32411888 PMCID: PMC7205156 DOI: 10.18332/tpc/109784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/01/2019] [Accepted: 06/02/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tobacco use remains the most preventable cause of death and disability, with prisoners being a neglected population of tobacco users. The aim was to determine the prevalence of tobacco use and attitudes toward its prevention among adult male prisoners. METHODS We conducted a descriptive cross-sectional study among 349 adult male inmates from three prisons in Khartoum State. The interview questionnaire included questions related to tobacco use status, type of tobacco used, previous attempts to quit, smoking inside a room, frequency of tobacco use before and after incarceration, and attitude toward its prevention. Chi-squared and paired t-test were used to compare between different variables, with the level of significance set at p≤0.05. RESULTS The majority (69.1%) were in the age group 30-50 years. All of the studied prisoners were tobacco users of which: 43.8% used oral snuff (toombak); 22.1% were cigarette smokers; 30.9% used both cigarette and toombak; 0.6% used cigarette and waterpipe; and 3.2% used cigarette, toombak and waterpipe. Toombak users (alone or with other types of tobacco) were 272 (78%) with the majority (62.4%) dipping 2-5 times per day. There were 96 (57%) cigarette smokers (alone or with other types), and waterpipe users were 12 (3.8%). The majority (74.6%) of cigarette users shared their cell with other toombak users. For the majority (79.6%), the number of cigarettes and snuff dipping per day was directly proportional to the period of incarceration. Almost all (99.1%) prisoners know the harmful effects of tobacco use, and 64.5% had previously attempted to quit. Also, 98% of tobacco users reported a desire to quit and expressed willingness to participate in a tobacco-cessation program. CONCLUSIONS Different patterns and methods of tobacco use were explored, and all the studied prisoners were users. Tobacco use increased after incarceration. The willingness to participate in tobacco-cessation counselling should be met with the implementation of a planned and well-designed prevention program.
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Affiliation(s)
- Elhadi M. Awooda
- Department of Restorative Dentistry, University of Medical Science and Technology, Khartoum, Sudan
| | - Dina E. Shashati
- Department of Restorative Dentistry, University of Medical Science and Technology, Khartoum, Sudan
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Valera P. Cigarette Smoke and Cancer Health Among Incarcerated Men in U.S. Northeastern Prison Facilities. JOURNAL OF CORRECTIONAL HEALTH CARE 2019; 25:265-276. [PMID: 31262213 DOI: 10.1177/1078345819856905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Incarcerated men, an understudied population, have not been the focus of cancer prevention studies. The Cancer Risk in Incarcerated Men Study was developed to examine smoking behaviors and cancer health among 236 incarcerated men. The participants were between 19 and 86 years of age. Only 30.5% of the sample reported receiving a cancer screening test and less than 5% reported being diagnosed with cancer. In terms of the cancer screening test provided, 43.6% reported having had a prostate-specific antigen test, 19.2% a fecal occult blood test, and 11.4% a sigmoidoscopy or a colonoscopy. Age was the only significant predictor of having a cancer screening procedure (B = .10, p < .001). This study demonstrates the need to promote cancer prevention studies among incarcerated populations.
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Affiliation(s)
- Pamela Valera
- 1 School of Public Health, Rutgers University, The State University of New Jersey, Piscataway, NJ, USA
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Sweeting H, Semple S, Demou E, Brown A, Hunt K. Predictors of opinions on prison smoking bans: Analyses of survey data from Scottish staff and prisoners. Tob Induc Dis 2019; 17:47. [PMID: 31516490 PMCID: PMC6662777 DOI: 10.18332/tid/109559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/25/2019] [Accepted: 05/22/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Policy-makers and practitioners need to understand characteristics associated with support for smoking restrictions to identify both potential allies and groups requiring particular support/targeted communication in the face of restrictions. Using data from prison staff and prisoners, we explored the structure and correlates of opinions relating to prison smoking bans. METHODS Questionnaires were completed by staff (online, N=1271; 27% return) and prisoners (paper-based, N=2512; 34%) in all 15 Scottish prisons in 2016–17. At that time, prisoners could smoke in their own cells and during outdoor recreation; staff smoking was prohibited anywhere on prison grounds. Staff and prisoner questionnaires included identical/very similar questions about opinions on smoking in prisons and prison smoking bans, own smoking behaviour, health and sociodemographic details. We also measured in every prison fine particulate matter (PM2.5) as a proxy for secondhand smoke (SHS) levels. RESULTS Principal components analysis identified two factors: ‘Positive about bans’ (higher scores among staff) and ‘Bans will be difficult’ (higher scores among prisoners). In multivariable analyses, ‘Positive about bans’ was associated with: not smoking (both staff and prisoners), better general health, more respiratory symptoms and working in an operational role among staff; and no asthma, more sensory symptoms, higher educational level and status/release date among prisoners. ‘Bans will be difficult’ was associated with: fewer sensory symptoms and lower prison SHS levels among staff and being a smoker among prisoners. In smoker-only analyses, heavier smokers were less positive about bans and more likely to believe bans will be difficult. CONCLUSIONS Results suggest it is possible to be positive about prison smoking bans whilst also recognising and/or concerned about potential operational difficulties, and that these opinions are associated with several characteristics additional to smoker status. Support for future prison bans may be stronger if staff have access to objective SHS exposure measures.
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Affiliation(s)
- Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Sean Semple
- Institute for Social Marketing, University of Stirling, Stirling, United Kingdom
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Ashley Brown
- Institute for Social Marketing, University of Stirling, Stirling, United Kingdom
| | - Kate Hunt
- Institute for Social Marketing, University of Stirling, Stirling, United Kingdom
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Abstract
To determine smoking behaviors, quit attempts, and cessation preferences among incarcerated smokers, a cross-sectional survey was given to a sample of inmates from three state prison facilities in the United States. A majority of Black smokers (62%) identified as smokers, and 38% identified as ex-smokers, as compared to 46.4 percent of smokers (and 53.6% of ex-smokers) in the non-Black group. There were significant differences in the number of cigarettes smoked per day with non-Black smokers smoking one pack (M = 20.44, standard deviation = 15.86) than Black smokers (M = 14.49, standard deviation = 13.43; t = -2.50, p = 0.014). Smoking cessation interventions are needed to reduce smoking during incarceration.
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Affiliation(s)
- Pamela Valera
- Rutgers School of Public Health, The State University of New Jersey, NJ, USA
| | - Andrea Reid
- Rutgers School of Public Health, The State University of New Jersey, NJ, USA
| | - Nicholas Acuna
- Rutgers School of Public Health, The State University of New Jersey, NJ, USA
| | - Daniel Mackey
- Lake Erie College of Osteopathic Medicine (LECOM), PA, USA
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Kinner SA, Young JT. Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis. Epidemiol Rev 2018; 40:4-11. [PMID: 29860342 PMCID: PMC5982728 DOI: 10.1093/epirev/mxx018] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 11/30/2017] [Indexed: 01/04/2023] Open
Abstract
The world prison population is growing at a rate that exceeds the rate of population growth. This issue of Epidemiologic Reviews comprises articles in which researchers summarize what is known about some of the key health issues facing people in prison, particularly in relation to human immunodeficiency virus and other blood-borne viral infections. A key recurring theme is that addressing the health needs of people in prison is important to reducing health inequalities at the population level—that prisoner health is public health. The reviews also highlight some critical evidence gaps, notably the lack of evidence from low- and middle-income countries, and the limited number of longitudinal studies in which health behaviors, health outcomes, or health service experiences after release from prison are documented. Despite growing evidence of the poor health of detained adolescents, none of the included reviews considered this population. Further research on the health of young people who cycle through juvenile detention should be a priority. Despite a rapidly growing literature on the health of people who experience incarceration, some critical health issues remain poorly understood, and there has been insufficient attention devoted to co-occurring health conditions and the consequent need for coordinated care. Key populations in custodial settings remain understudied, limiting capacity to develop targeted, evidence-based responses to their health needs. The quality of many studies is suboptimal, and although rigorous, independent research in correctional settings can be challenging, it is not impossible and is critical to laying the groundwork for evidence-based reform.
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Affiliation(s)
- Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne Australia
- Mater Research Institute-UQ, University of Queensland, Brisbane Australia
- Griffith Criminology Institute, Griffith University, Brisbane Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne Australia
- Correspondence to Stuart A. Kinner, Centre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Flemington Road, Parkville VIC 3052 Australia (e-mail: )
| | - Jesse T Young
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne Australia
- Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth Australia
- National Drug Research Institute, Curtin University, Perth Australia
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Inmates with Harmful Substance Use Increase Both Exercise and Nicotine Use Under Incarceration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122663. [PMID: 30486386 PMCID: PMC6313574 DOI: 10.3390/ijerph15122663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 12/21/2022]
Abstract
Exercise is increasingly understood as an important resource for people who engage in harmful substance use, including those in prison. Little is known about how inmates adopt various health behaviors during incarceration, without interventions. This cross-sectional study analyzed self-reports from 1464 inmates in Norwegian prisons in 2013–2014, compared them according to harmful substance use pre-incarceration, and explored changes in exercise and nicotine use during incarceration. Results were presented in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Inmates with harmful substance use reported higher rates of smoking, smokeless tobacco, and physical inactivity pre-incarceration than inmates without harmful use. However, inmates with harmful use also exhibited more behavioral changes: they adopted exercise, ceased smoking, and adopted smokeless tobacco at higher rates during incarceration than the non-harmful group, to the extent that inmates with harmful use exercised during incarceration more. Exercise is being taken up by a significant proportion of inmates, and may in particular be a replacement behavior for substance use. However, unhealthy behaviors also begin or are maintained. If prisons were used as an arena to facilitate healthy behaviors, the public health benefits to a marginalized group such as substance-using inmates could be substantial.
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Jin X, Kinner SA, Hopkins R, Stockings E, Courtney RJ, Shakeshaft A, Petrie D, Dobbins T, Dolan K. Brief intervention on Smoking, Nutrition, Alcohol and Physical (SNAP) inactivity for smoking relapse prevention after release from smoke-free prisons: a study protocol for a multicentre, investigator-blinded, randomised controlled trial. BMJ Open 2018; 8:e021326. [PMID: 30341114 PMCID: PMC6196819 DOI: 10.1136/bmjopen-2017-021326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 05/17/2018] [Accepted: 07/19/2018] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Smoking remains the leading risk factor for disease burden and mortality worldwide. Heavy Smoking is often associated with poor Nutrition, Alcohol abuse and Physical inactivity (known as 'SNAP'). Australia's first prison smoking ban was introduced in the Northern Territory in July 2013. However, relapse to smoking after release from prison is normative. Holistic and cost-effective interventions are needed to maintain post-release abstinence to realise the potential public health impact of smoke-free prison policies. Rigorous, large-scale trials of innovative and scalable interventions are crucial to inform tobacco control policies in correctional settings. METHODS AND ANALYSIS This multicentre, investigator-blinded, randomised parallel superiority trial will evaluate the effectiveness of a brief intervention on SNAP versus usual care in preventing smoking relapse among people released from smoke-free prisons in the Northern Territory, Australia. A maximum of 824 participants will be enrolled and randomly assigned to either SNAP intervention or usual care at a 1:1 ratio at baseline. The primary endpoint is self-reported continuous smoking abstinence three months after release from prison, verified by breath carbon monoxide test. Secondary endpoints include seven-day point prevalence abstinence, time to first cigarette, number of cigarettes smoked post release, Health Eating Index for Australian Adults, Alcohol Use Disorder Identification Test-Consumption and International Physical Activity Questionnaire scores. The primary endpoint will be analysed on an intention-to-treat basis using a simple log binomial regression model with multiple imputation for missing outcome data. A cost-effectiveness analysis of the brief intervention will be conducted subsequently. ETHICS AND DISSEMINATION This study was approved by the University of New South Wales Human Research Ethics Committee (HREC), Menzies HREC and Central Australia HREC. Primary results of the trial and each of the secondary endpoints will be submitted for publication in a peer-review journal. TRIAL REGISTRATION NUMBER ACTRN12617000217303; Pre-results.
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Affiliation(s)
- Xingzhong Jin
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
| | - Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn Hopkins
- Northern Territory Correctional Services, Darwin, Northern Territory, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Dennis Petrie
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - Timothy Dobbins
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Kate Dolan
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
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Elkhalifa AM. Effects of cigarette smoking on coagulation screening tests and platelet counts in a Sudanese male adults population. Saudi Med J 2018; 39:897-901. [PMID: 30251733 PMCID: PMC6201005 DOI: 10.15537/smj.2018.9.22630] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives: To study the effects of heavy cigarette smoking on coagulation (CGG) screening tests and platelet counts (PLTs) in a Sudanese male adults population. Methods: A case control study was conducted at both Kosti and Gabalein towns, Sudan, during October 2016 to May 2017. A 100 adult cigarette smokers were selected and another 100 matched non-smokers were selected as healthy controls. Blood samples were collected in trisodium citrate anti-coagulant for prothrombin time (PT), partial thromboplastin time (PTT), and international normalized ratio (INR), analyzed using standard methods (co-agulometer machine) and Ethylenediaminetetraacetic acid for the platelet counts, using an automated haematology analyzer (Sysmex, Tokoyo, Japan). Results: The results showed that the mean platelet counts were significantly lower in the smokers (183x103/cmm±64x103/cmm) versus (244x103/cmm±38x103/cmm) in non-smokers, (p<0.000). Pearson correlation analysis suggested a weak negative correlation between platelet counts with the duration of smoking (r= -0.289, p<0.004) and the age of the smokers (r= -0.238, p<0.017). The mean PT and INR were also significantly lower in smokers (12.9±1.2 seconds) compared with the non-smokers (13.7±1.04 seconds, p<0.000), for PT and (0.95±0.09 versus 1.01±0.08, p<0.000) for INR. In contrast, PTT had no significant variation in smokers (30.5±3.8 seconds) and the non-smokers (37.9±4.6 seconds). A p-value>0.05 was considered significant. Conclusion: Cigarette smokers tend to have lower platelet counts, shorter PT, and INR values, compared to non-smokers. Therefore, smoking might be associated with bleeding disorders but further investigations are needed.
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Affiliation(s)
- Ahmed M Elkhalifa
- The Saudi Electronic University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Fazel S. Editorial: Synthesizing the Evidence on Prisoner Health-Taking Stock and Moving Forward. Am J Epidemiol 2018; 187:1137-1139. [PMID: 29718088 PMCID: PMC5982786 DOI: 10.1093/aje/kwx375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 12/08/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford United Kingdom
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