268547 Smoking Patterns Among Parolees in the San Francisco Bay Area

Monday, October 29, 2012

Benjamin Howell , School of Public Health, University of California, Berkeley, Berkeley, CA
Joseph Guydish, PhD, MPH , Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Alex Kral, PhD , Urban Health Program, RTI International, San Francisco, CA
Megan Comfort , Urban Health Program, RTI International, San Francisco, CA
Background: Formerly incarcerated men have significantly higher rates of mortality and morbidity than the general population, disparities that have been partially attributed to higher rates of smoking-related illnesses such as cardiovascular disease, pulmonary disease and cancer.

Methods: We analyzed data from 172 men who were released from California state prisons (where smoking is prohibited) to San Francisco and Oakland between 2009 and 2011. We analyzed the association between amount of lifetime history of incarceration and self-reported smoking status, in multivariate analysis. We used a significance level of p < 0.05 for main effects, and p < 0.10 for interactions.

Results: Seventy-four percent of the men in our sample reported being current smokers. In logistic regression model of current smoking, we found an interaction between the number of years of lifetime incarceration and age (p=.09). Among 30 year-old men, a 5 year increase in lifetime incarceration was associated with 1.58 higher adjusted odds of smoking (p=.08). Among 40 year old men, a 5 year increase in lifetime incarceration was associated with a 1.26 higher adjusted odds of smoking (p=.15) and among 50 year old men, a 5 year increase in lifetime incarceration was associated with a 1.01 higher adjusted odds of smoking (p=.96). Additionally, we found that illicit substance use was associated with a 2.33 higher adjusted odds of smoking (p=.04).

Conclusions: Given the high prevalence of smoking among former prisoners and their high tobacco-related mortality rates, these findings highlight a potentially important determinant and setting (prison and parole systems) for intervention.

Learning Areas:
Epidemiology

Learning Objectives:
Learn about the relationship between incarceration history and smoking rates in the formerly incarcerated. Compare smoking rates among the formerly incarcerated to the smoking rates among similar situated populations in the context of the prohibition of smoking in California prisons. Discuss possible interventions to reduce smoking rates among the formerly incarcerated to prevent smoking-related health disparities in this population.

Keywords: Parolees, Smoking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently pursuing a MPH focusing in Epidemiology at the University of California, Berkeley and a MD at the University of California, San Francisco. Among my scientific interests have been health disparities among prisoners and parolees. My co-authors have been the principal or co-principal of multiple federally funded grants using mixed methods focusing on the study of prison health and drug use.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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