Study Suggests Interventions Are Needed to Sustain Tobacco Abstinence After Release From Prison

A study by Jennifer G. Clarke, M.D., M.P.H., of Memorial Hospital of Rhode Island, Pawtucket, and colleagues suggests that behavioral intervention provided prior to release from prison improves tobacco abstinence in the community. (Online First)

A total of 262 inmates (35 percent female) were recruited approximately 8 weeks prior to their release from a smoke-free prison and were randomized to 6 weekly sessions of either education videos (control) or the WISE intervention (Working Inside for Smoking Elimination). Continued smoking abstinence was defined as 7-day point-prevalence abstinence validated by urine cotinine measurement.

At the 3-week follow-up after release from prison, 25 percent of participants in the WISE intervention (31 of 122) and 7 percent of the control participants (9 of 125) continued to be tobacco free. Hispanic ethnicity, a plan to remain abstinent, and being in prison for more than 6 months were all associated with increased likelihood of remaining abstinent. Nonsmokers at the 3-week follow-up had an additional follow-up 3 months after release, and overall 12 percent of the participants in the WISE intervention (14 of 122) and 2 percent of the control participants (3 of 125) were tobacco free at 3 months.

“In summary, our study shows that an intervention based on MI [motivational interviewing] and CBT [cognitive behavioral therapy] can improve continued smoking abstinence after prison release…,” the study concludes.

(JAMA Intern Med. Published online April 8, 2013. doi:10.1001/jamainternmed.2013.197.