Research Article: Tobacco use among non-elderly adults with and without criminal justice involvement in the past year: United States, 2008–2016

Date Published: January 11, 2019

Publisher: BioMed Central

Author(s): Tyler N. A. Winkelman, Katherine Diaz Vickery, Andrew M. Busch.

http://doi.org/10.1186/s13722-019-0131-y

Abstract

Tobacco use remains the leading cause of preventable disease and death in the United States and is concentrated among disadvantaged populations, including individuals with a history of criminal justice involvement. However, tobacco use among individuals with a history of criminal justice involvement has been understudied in the United States, and data are needed to inform policy and practice.

We used data from the 2008–2016 National Survey on Drug Use and Health (unweighted N = 330,130) to examine trends in tobacco use, categories of tobacco use, characteristics of cigarette use, and health care utilization and tobacco use screening among individuals (aged 18–64) with and without a history of criminal justice involvement in the past year. We used multiple logistic and Poisson regression models with predictive margins to provide adjusted prevalence estimates.

The weighted sample in each year was, on average, representative of 8,693,171 individuals with a history of criminal justice involvement in the past year and 182,817,228 individuals with no history of criminal justice involvement in the past year. Tobacco use was significantly more common among individuals with a history of criminal justice involvement compared with individuals with no criminal justice involvement, and disparities increased over time (Difference in adjusted relative differences: − 10.2% [95% CI − 17.7 to − 2.7]). In 2016, tobacco use prevalence was more than two times higher among individuals with a history of criminal justice involvement (62.9% [95% CI 59.9–66.0] vs. 27.6% [95% CI 26.9–28.3]). Individuals with a history of criminal justice involvement who smoked reported a significantly earlier age of cigarette initiation, more cigarettes used per day, and higher levels of nicotine dependence and chronic obstructive pulmonary disease. Individuals with a history of criminal justice involvement were less likely to report an outpatient medical visit in the past year and, among those reporting an outpatient medical visit, were less likely to be asked about tobacco use, but paradoxically, more likely to report being advised to quit.

Novel programs and tobacco control policies are needed to address persistently high rates of tobacco use and reduce cardiovascular morbidity and mortality among individuals with a history of criminal justice involvement.

Partial Text

Tobacco use remains the leading cause of preventable disease and death in the United States [1]. Cigarette smoking, the most common form of tobacco use, is responsible for over 450,000 deaths and $300 million in economic costs every year [2]. While smoking rates among the general US population have declined substantially over the past several decades, decreases have been disproportionately concentrated among higher-income groups [1, 3]. Therefore, smoking is now highly concentrated among disadvantaged populations, including individuals involved in the criminal justice system (i.e., individuals who have been incarcerated in jail or prison, on probation/parole, or arrested) [4, 5]. High levels of smoking among individuals in prisons contribute to excess age-adjusted mortality and years of potential life lost in this population [6, 7].

Among a nationally representative sample of non-elderly adults, tobacco use was more than twice as common among individuals with criminal justice involvement in the past year compared to those with no criminal justice involvement. Disparities between these two groups grew over time. Tobacco use prevalence declined 12.8% among individuals with no criminal justice involvement—five times larger than the change among individuals with criminal justice involvement in the past year (− 2.6%). Current approaches to tobacco use reduction, including public health efforts [27–29] and interventions within health care settings [30, 31], have not had a measurable impact among individuals with a history of criminal justice involvement on a population level. New approaches are needed to reduce tobacco use disparities among individuals involved in the criminal justice system.

Tobacco use prevalence among individuals involved in the criminal justice system is more than double the prevalence of tobacco use in the general population, and disparities have worsened over the past 9 years. Novel programs and tobacco control policies are needed to address persistently high rates of tobacco use and thereby reduce cardiovascular morbidity and mortality among individuals with a history of criminal justice involvement.

 

Source:

http://doi.org/10.1186/s13722-019-0131-y

 

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