Decreased Mortality Rates of Inmates With Mental Illness After a Tobacco-Free Prison Policy

Dickert, Jeff; Williams, Jill M.; Reeves, Roy R.; Gara, Michael A.; DeBilio, Lisa

doi:10.1176/appi.ps.201400429

Cited by 16 publications

(11 citation statements)

References 14 publications

(11 reference statements)

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“…While evidence from the USA shows that these smoke‐free policies have significantly improved the health of people in prison, these policies have resulted in some unintended consequences. One such example is the diverted use of nicotine replacement therapy (NRT), where prisoners are substituting traditional cigarettes by creating their own cigarettes out of NRT supplied by correctional authorities.…”

Section: Introductionmentioning

confidence: 99%

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Constituents of “teabacco”: A forensic analysis of cigarettes made from diverted nicotine replacement therapy lozenges in smoke‐free prisons

Mitchell

Puljević

Coomber

et al. 2018

Drug Testing and Analysis

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Following the implementation of prison smoke-free policies, there have been reports of prisoners creating substitute cigarettes made from nicotine replacement therapy patches or lozenges infused with tea leaves ("teabacco"). No studies have analyzed the chemical constituents of teabacco made from nicotine lozenges, so as to document any potential related health hazards. Teabacco samples were made by a participant who reported creating teabacco while incarcerated in a smoke-free prison in Queensland, Australia, and the process was video-recorded for replication in a laboratory. A simple linear smoking system captured the teabacco smoke for analysis. Inductively coupled plasma optical emission spectroscopy (ICP-OES) was used to analyze elemental composition and gas chromatography coupled with a mass spectrometer (GC-MS) analyzed the captured smoke using the National Institute of Standards and Technology mass spectral library. Analyses determined that quantities of copper, aluminum, and lead concentrations, and levels of inhaled total particulate matter, were above recommended guidelines for safe ingestion. Analysis of teabacco smoke using GC-MS identified potentially toxic compounds catechol and nicotine. However, our findings show that smoking this form of teabacco is less harmful than smoking teabacco made from nicotine patches, or smoking traditional tobacco cigarettes. Considering the limited potential health harm of smoking teabacco made from lozenges, and that nicotine lozenges represent the only form of smoking cessation support for individuals entering smoke-free prisons, we caution against the removal of nicotine lozenges from Queensland's prisons, at least until further research directly establishes health harms associated with this form of teabacco.

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Section: Introductionmentioning

confidence: 99%

“…While evidence from the USA shows that these smoke-free policies have significantly improved the health of people in prison, 3,12 these policies have resulted in some unintended consequences.…”

mentioning

confidence: 99%

Constituents of “teabacco”: A forensic analysis of cigarettes made from diverted nicotine replacement therapy lozenges in smoke‐free prisons

Mitchell

Puljević

Coomber

et al. 2018

Drug Testing and Analysis

View full text Add to dashboard Cite

show abstract

“…Two US‐based studies reported significant declines in prisoner deaths following the introduction of correctional smoke‐free policies , providing support for their positive impact on prisoner health. However, one unintended consequence of the policy, reported in some correctional facilities, has been prisoners’ creation of cigarettes using nicotine replacement therapy (NRT) provided by correctional or health authorities to assist with nicotine withdrawal.…”

Section: Introductionmentioning

confidence: 99%

‘Teabacco’: Smoking of nicotine‐infused tea as an unintended consequence of prison smoking bans

Puljević

Coomber

Kinner

et al. 2018

Drug and Alcohol Review

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“…Despite good evidence that smoke-free policies result in health benefits for people in prison,23 24 including significant reductions in smoking-related deaths,7 they do not ensure complete abstinence for all people in prisons. The prevalence of any level of tobacco use in smoke-free prisons has been reported between 20% and 76%,4 however no study has reported this prevalence in an Australian prison.…”

Section: Introductionmentioning

confidence: 99%

Staying Quit After Release (SQuARe) trial protocol: a randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia

et al. 2019

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IntroductionSmoke-free policies have been introduced in prisons internationally. However, high rates of relapse to smoking after release from prison indicate that these policies typically result in short-term smoking cessation only. These high rates of relapse, combined with a lack of investment in relapse prevention, highlight a missed opportunity to improve the health of a population who smoke tobacco at two to six times the rate of the general population. This paper describes the rationale and design of a randomised controlled trial, testing the effectiveness of a caseworker-delivered intervention promoting smoking cessation among former smokers released from smoke-free prisons in Victoria, Australia.Methods and analysisThe multicomponent, brief intervention consists of behavioural counselling, provision of nicotine spray and referral to Quitline and primary care to promote use of government-subsidised smoking cessation pharmacotherapy. The intervention is embedded in routine service delivery and is administered at three time points: one prerelease and two postrelease from prison. Control group participants will receive usual care. Smoking abstinence will be assessed at 1 and 3 months postrelease, and confirmed with carbon monoxide breath testing. Linkage of participant records to survey and routinely collected administrative data will provide further information on postrelease use of health services and prescribed medication.Ethics and disseminationEthical approval has been obtained from the Corrections Victoria Research Committee, the Victorian Department of Justice Human Research Ethics Committee, the Department of Human Services External Request Evaluation Committee and the University of Melbourne Human Research Ethics Committee. Results will be submitted to major international health-focused journals. In case of success, findings will assist policymakers to implement urgently needed interventions promoting the maintenance of prison-initiated smoking abstinence after release, to reduce the health disparities experienced by this marginalised population.Trial registration numberACTRN12618000072213; Pre-results.

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Decreased Mortality Rates of Inmates With Mental Illness After a Tobacco-Free Prison Policy

Abstract: This striking correlation of quick and substantial reduction of mortality among individuals with a mental illness in association with the reduction and subsequent ban of smoking suggests that smoking may play a major role in the reduced life span of persons with mental illness.

Cited by 16 publications

References 14 publications

Constituents of “teabacco”: A forensic analysis of cigarettes made from diverted nicotine replacement therapy lozenges in smoke‐free prisons

Constituents of “teabacco”: A forensic analysis of cigarettes made from diverted nicotine replacement therapy lozenges in smoke‐free prisons

‘Teabacco’: Smoking of nicotine‐infused tea as an unintended consequence of prison smoking bans

Staying Quit After Release (SQuARe) trial protocol: a randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia

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