© Behavioral Health and Wellness Program

December 2017

Providing Tobacco Cessation Services in Correctional Settings: Frameworks, Feasibility, and Effectiveness

The Justice-Involved Tobacco Cessation Project

1

TableofContents

I.Introduction 3II.ABackgroundforIntervention 3

Justice-InvolvedSmokers 3

TobaccoUseinCorrection 5

ConsiderationsforCommunityCorrections 6

MaricopaCounty 6III.Evidence-BasedStrategiesforTobaccoCessation 8

InterventionsintheGeneralPopulation 8

OverviewofInterventionsfortheJustice-Involved 9

RecommendedTreatmentModels 10

Tobacco-FreePoliciesinCorrectionalSystems 12

Counseling/BehavioralInterventionsforTobaccoCessationinJIPopulations 13

PharmacotherapyforTobaccoCessationinJIPopulations 16

TelephonicCessationServices–TheASHLine 19

2

TobaccoTreatmentSpecialists 19

IV.Conclusion 20

V.WorksCited 21

3

I.IntroductionThenumberofpersonsincarceratedintheU.S.isstaggering:U.S.prisonshousemorethan1.5millioninmates(Sabol&Minton,2008).Thesejustice-involved(JI)individualssmokeatthreetofourtimestherateofthegeneralpopulation.Therefore,while16.8%oftheadultpopulationin�theU.S.smokescigarettes,thesmokingrateforJIpopulationsisestimatedtobebetween70%-80%(CDC,2015;Cropseyetal.,2010).Unsurprisinglythen,theleadingcausesofdeathamongindividualswhohavebeenjailedareallassociatedwithordirectlycausedbytobaccouse,including:suicide,heartdisease,drugoralcoholintoxication,cancer,andliverdiseases(Binswangeretal.,2011;Binswangeretal.,2007;Binswanger,Krueger,&Steiner,2009;UnitedStatesDepartmentofHealthandHumanServices[USDHHS],2006).Inmatesandparoleeswhousetobaccoproductsaremorelikelytodevelopchronichealthconditionsthatareexpensivetomanageandputunduestrainontaxpayer-fundedcriminaljusticeandhealthcareprograms.ThesehealthdisparitiesfollowJIindividualsfromincarcerationbackintotheircommunitiesafterrelease.Thereisacriticalneedfortobaccocessationinterventionsincorrectionssettings,butsuchservicescontinuetobetheexceptionratherthanastandardofcare.Evenso,thereisincreasingevidencesuggestingthatinterventionsinthecriminaljusticesystemarebothfeasibleandeffective.ThisreportbeginsbyprovidingbackgroundinformationregardingJIindividuals’tobaccouse,correctionalsettingsandtobacco-freepolicies,considerationsforcommunitycorrections,andfindingsspecificallyforMaricopaCounty.Thisbackgroundisinstructiveinunderstandinghowevidence-basedstrategiesmightbeutilizedacrossarangeofcorrectionssettings.Thereportthenmovesintoprovencessationstrategiesforthegeneralpopulation,howtheseinterventionsandresourcescanbeappliedtoJIpopulations,andtheevidencebasewehavethusfarforprovidingJIindividualssuchtreatment.

4

II.ABackgroundforInterventionJustice-InvolvedSmokers:ThehighrateoftobaccouseamongtheJIpopulationispartiallyattributabletothelargedemographicoverlapbetweentheJIpopulationandother“underserved”populationswithsimilarlyhighsmokingrates.Thesegroupsincludeindividualswithlowsocioeconomicstatus,behavioralhealthconditions,and/orsubstanceusedisorders.Lowsocioeconomicstatus(SES),ameasuretypicallycomprisedofvariablessuchasincomeandeducationallevel,isanindicatorofhighratesoftobaccouse(Barbeau,Krieger,&Soobader,2004).Forinstance,povertyhasbeenwellestablishedinthescientificliteratureasasignificantriskfactorfortobaccouse(Barbeau,Krieger,&Soobader,2004),andJIindividualsoftencomefromsocioeconomicallydisadvantagedbackgrounds.Itisestimatedthat26%ofindividualsbelowpovertylevelsmoke,versusonly15%ofthoseatorabovepovertylevel.Forthosewhoarehomeless,prevalenceratesareevenhigher–estimatedtobebetween70%-80%(Okuyemietal.,2013;Torchallaetal.,2011).Additionally,educationalattainment,anothervariableofSESstatus,isanindicatoroftobaccouse.TobaccouseratesforindividualswithaGEDis43%,versusonly8%forthosewithanundergraduatedegree.Asagroup,JIindividualshaverelativelylowratesofeducationalattainment.Whileonly18%ofthegeneralpopulationhaslessthanahighschooldiploma,40%ofindividualsinstateprisons,47%injails,and31%incommunitycorrectionshavelessthanahighschooldiploma(Wolf,2003).Moreover,individualswithinthebehavioralhealthpopulation(definedashavingmentalillnessesorsubstanceusedisorders)alsohaveahighsmokingprevalencerate.Researchestimatesthatindividualswithbehavioralhealthconditionsarenicotinedependentatratestwotothreetimesthegeneralpopulation(CDC,2013).Withinthebehavioralhealthpopulation,prevalenceratesareestimatedtorangebetween32%-90%dependinguponthediagnosis(Grantetal.,2004;Lasseretal.,2000;Morrisetal.,2009;Williams&Zeidonis,2004).Althoughonly25%oftheU.S.populationhasabehavioralhealthcondition,thisgroupconsumes40%ofallcigarettessmoked(SubstanceAbuseandMentalHealthServicesAdministration[SAMHSA]2013).AdisproportionateshareoftheJIpopulationhasabehavioralhealthcondition.Recentestimatesindicatethat17–34%ofjailinmateshavearecenthistoryofmentaldisorders(Steadmanetal.,2009;Steadmanetal.,2013),andwelloverhalfofallincarceratedindividualshavesignificantsubstanceuseproblems(Lurigio,2011;Steadmanetal.,2013).TheoverlapbetweentheJIandbehavioralhealthpopulationsmaythencontributetothehighsmokingprevalencerateamongtheJI.Despitethesefacts,smokingamongJIindividualsisalargelyignoredpublichealthepidemic.Althoughthepast30yearshasseenextensiveresearchandstudyoftobaccocessationwithinthegeneralpopulation,individualswhoareinvolvedinthecriminaljusticesystemremainnotablyabsentfromthescientificliterature.Tobaccocessationinterventionswiththispopulationcontinuetobeunderstudied,andempirically-validatedtreatmentsremainsparsedespitetherecentincreaseincorrectionalsystemtobacco/smokingbans(Cropseyetal.,2010;

5

Kauffmanetal.,2011).Failingtoaddresstobaccouseinthispopulationhassignificantfinancial,social,andmedicalconsequencesthatareharmfultoindividualswithinthesystemandimpactthegreatercommunity(TobaccoControlLegalConsortium,2012;Binswangeretal.,2011;Wilperetal.,2009).WhileJIsmokersoftenwanttoquitsmoking,theyarenotaffordedthesameopportunitiestoquitasthegeneralpopulation(Kauffmanetal.,2010).TheimmensesizeoftheU.S.correctionssystemhasmadeitchallengingforcriminaljusticeinstitutionstooperateefficientlywhilealsoprovidingcomprehensive,qualityhealthcareservices(Hammet,2006).Evidenceofcomprehensivewellnessprogrammingisscarce.Althoughthedirectrelationshipbetweenincarcerationandhealthoutcomesiscomplex,accesstoqualityhealthcareandtobaccocessationserviceswhileincarceratedandwhenreenteringcommunitiesiscritical(Binswangeretal.,2011).Yettherearefewavailablejailorcommunity-basedtobaccocessationservicestailoredtothispopulation.However,itisknownthatcessationinterventionsincreasetheabilityofinmatestoquit(Clarkeetal.,2013;Cork,2012;Richmondetal.,2006).Additionally,researchindicatesthatasindividualsincorrectionalsettingsimprovetheirhealth,medicalcostsaswellasproblemswithgeneralsecuritydecrease(Glaser&Greifinger,1993;Kimetal.,1997).Atrelease,communitiesbenefitwhenindividualsreentertheircommunitieswithincreasedhealthliteracy,healthyhabits,andgreaterself-efficacy(Conklin,Lincoln,&Tuthill,2000;Freudenberg,2001;Glaser&Greifinger,1993;Hammet,Roberts,&Kennedy,2001;Kimetal.,1997).Tobaccocontrolstrategiessavelives,improvequalityoflife,andarecosteffective(Fioreetal.,2008).Thecriminaljusticesystemoffersuniqueaccesspointstodeliversmokinginterventionstovulnerableandunderservedindividuals(Donahue,2009).Themajorityofprisonersareawareoftherisksthatareassociatedwithtobaccouseandhaveadesiretoquit,makingprisonsandthecorrectionalsystemmorebroadlyan“idealsettingforintervention”(Kauffmanetal.,2011).TobaccoUseinCorrections:Tobaccouseincriminaljusticesettingshashistoricallybeencondoned(MacDonaldetal.,2010),andcorrectionsstaffcommonlypossessnegativeattitudestowardcessationservices(MacAskill&Hayton,2007).Tobaccohastraditionallybeenviewedasoneoffew“privileges”forprisoners,andprisonershavebeenfoundtorelyontobaccousetocombatboredomandstresswhileincarcerated(Cork,2012).Asrecentlyasthelate1980s,prisonsissuedtobaccotoprisonersforfree(Kauffmanetal.,2008).Today,cigarettesandothertobaccoproductsarestillsoldinmanycommissaries.However,followinga1993SupremeCourtdecisionthatruledthatsecondhandsmokeexposureinprisonscouldconstitutecruelandunusualpunishment,andthusviolatethe8thAmendment,prisontobaccopoliciesbegantochange(Cork,2012).In2004,theFederalBureauofPrisonsinstitutedasmokingbaninfederalprisons.Since2004,othercorrectionalsystemssuchasthe

6

AmericanJailAssociation,theAmericanCorrectionalAssociation,andtheNationalCommissiononCorrectionalHealthCarehavealsoadoptedsmoke-freeresolutionsthatpromotetobacco-freepoliciesinjailsandprisons(AmericanNonsmokers’RightsFoundation,2012).Today,allfederalcorrectionalfacilities,aswellasmoststateandlocalfacilities,haveadoptedvaryingdegreesofsmoke-freeortobacco-freepolicies(Clarkeetal.,2011;Cork,2012).Nevertheless,veryfewcriminaljusticefacilitiesoffertobaccocessationservicesforinmates,probationers,parolees,orstaffmembers.Infact,oneliteraturereviewfoundthatmosttobacco-freecorrectionalinstitutionsdonotoffercessationsupport(Kennedy,Davis,&Thorne,2015).Anotherstudyfoundthatthelimitedcessationassistancethatisavailablemaynotbeadequate;ofallstatecorrectionalfacilitiesthatprovidecessationassistance,themajorityoftheseprogramsarelimitedtotheprovisionofeducationalmaterialsorotherunspecifiedassistance(Cork,2012).Consequently,thereremainsagreatneedforcessationsupportwithincorrectionalinstitutionsaswellaswithincommunityreentryprogramming(deAndrande&Kinner,2017).ConsiderationsforCommunityCorrections:Studieshavefoundthatsmokingratesamongindividualsundercommunitycorrectionssupervisionarecomparabletothosewhoareincarcerated–morethan70%(Cropseyetal.,2010).However,therearesomespecificdemographicconsiderationsthatshouldbetakenintoaccountwhentailoringatobaccocessationprogramtomeettheneedsofindividualsundercommunitycorrectionssupervision.Forinstance,thepopulationundercommunitycorrectionssupervisionislargelycomprisedofyoungadults.Therelativelyyoungageofthecommunitycorrectionspopulationcreatesanopportunitytoachievegreaterlong-termbenefitsfromearlytobaccointerventions.Ontheotherhand,JIindividualsundercommunitycorrectionssupervisionmaybelesslikelythanolderpopulationstoseeorhaveexperiencedthedetrimentalmedicaleffectsoftheirtobaccouse(Cropseyetal.,2010),potentiallyaffectingtheirmotivationstoquit.Despitehighprevalenceratesfortobaccousewithincommunitycorrections,theseJIindividualsareinterestedinquitting.Infact,whensurveyed,morethan50%oftobaccousersundercommunitycorrectionssupervisionreportinterestintobaccocessationprogramming(Cropseyetal.,2010).Inaddition,60%oftheseindividualsalsoreportinterestinusingpharmacotherapytoassistquitattempts(Cropseyetal.,2010).MaricopaCounty:JIindividualsinMaricopaCountyreflectnationwidetrends.AccordingtoMaricopaCountyPublicHealth’s2017AdultProbationreport,“SmokingQuestionnaireforAdultProbationersReport–MaricopaCounty,”55%ofadultprobationersreportedthattheyarecurrentsmokers.TheDrugCourtsampleandtheSeriousMentalIllness(SMI)samplehadthehighestratesoverall,around83%and80%respectively.Ofallofsmokers,78%reporteddailytobaccouse

7

while21%reportedonlysmokingonsomedays.Smokersreportedthattheyusedcigarettesprimarilyforstressreductionandweightcontrol.However,thereportalsorevealedthatmanyofthesesmokersareinterestedinquitting.Around37%ofallsmokersratedtheir“readinesstoquit”asan8,9,or10ona1-10scalewhere10indicatedthattheywere“veryready”toquit.ReadinessrateswerehighestattheWesternRegionalCenterandwerelowestamongtheSMIsample.Thisinterestinquittingreinforcesboththeimportanceofandthepossibilityforsuccessfultobaccocessationinterventionswithinthecountycorrectionalsystem.CommunitycorrectionscomprisesasignificantportionoftheMaricopaCountybudget,andcorrectionscostsappeartobeontherise.AccordingtotheMorrisonInstitute(2015),in2010theaveragecostofincarcerationperoffenderforMaricopaCountywas$24,805(orabout$67.96perday).Incomparison,in2016thecostofincarcerationperoffenderwasestimatedtobearound$31,203(orabout$85.49perday).ItcanbeinferredthatJItobaccouserscostthecountymuchmorethannon-usersduetomedicalandpsychiatriccomorbiditiesaswellashospitalizations,manyofwhichareassociatedwithtobaccouse(FloridaStateUniversity,2017).Tobaccocessationwithinthecountycorrectionalsystemsoffersameanstoaddresstheserisingcosts.

8

III.Evidence-BasedStrategiesforTobaccoCessationInterventionsintheGeneralPopulation:Whenpeopletrytoquitontheirown,fewerthan5%ofquitattemptsaresuccessful(Fioreetal.,2008).However,therearemanydifferentevidence-basedoptionsfortobaccocessation.Treatmentmethodsincludetobaccocessationmedications,counseling,supportiveeducationabouttobaccouse,andreferralstotobaccocessationresources.Themosteffectiveapproachtotobaccocessationcombinesmultipletreatmentstrategies.Treatmentsthatcombinetobaccocessationmedicationswithbehavioralinterventionshavethebestratesoftreatmentacceptanceandcessation(Fiore&Baker,2011).

Tobaccocessationmedicationisusedtodecreasephysicalwithdrawalsymptoms(Benowitz,2008).Cessationmedicationshelpindividualstofeelcomfortablewhilequittingandallowthemtofocusontheirchangingbehaviorsrelatedtotobaccouse.Mostmedicationsfortobaccocessationapproximatelydoublethecessationratesatsixmonths(Fiore&Baker,2011).Combinedtherapies(usingtwoormoretobaccocessationmedications)aremoreeffective,witha33%-37%abstinencerateversus19%-26%withasinglemedication(Fioreetal.,2008).Startingnicotinereplacementtherapy(NRT)twoormoreweekspriortothequitdatecanbebeneficial(Lindson&Aveyard,

2011).Inonestudy,individualswhousedthepatchpriortoquittingweretwiceaslikelytohavemaintainedtheirabstinenceasthosewhoinitiatedthepatchontheirquitdate(Shiffman&Ferguson,2008;Roseetal.,2009).Counselinggenerallybeginswithabriefinterventionandscreeningtoassesstheintensityoftheclient’snicotinedependence.Counselingcantakeavarietyofforms,includingindividual,group,ortelephoniccounseling(USPublicHealthService,2009).Counselingfortobaccocessationcanincludecognitivebehavioralstrategiestopracticeskillsbuildingandproblemsolving,MotivationalInterviewing(MI)toincreaseinterestinandreadinesstoquit,andpsychoeducationalcomponents.Counselingforcessationdoesnotneedtobeintensivetobeeffective.Itisestimatedthatinterventionswithnoperson-to-personcontact,suchasreceivingself-helpinformationonly,haveanabstinencerateofaround10.9%.Withminimalcounseling(definedaslessthan3minutes),lowintensitycounseling(definedasbetween3-10minutes),andhighintensity

TreatmentFormat AbstinenceRate

Unaided 4-7%

Self-help 11-14%

Quitline 11-15%

Individualcounseling 15-19%

Groupcounseling 12-16%

Medicationalone 22%

Medication+counseling 25-30%

9

counseling(definedasgreaterthan10minutes),estimatedabstinenceratesincreaseto13.4%,16%,and22.1%,respectively(BureauofPublicHealthService,2008).Finally,tobaccocessationresources–likequitlines–cansignificantlyincreaseabstinenceratescomparedtominimalornocounseling.Referralstoresourceslikequitlinecounselingcansignificantlyimproveabstinenceratescomparedtomedicationalone(Fioreetal.,2008).OverviewofInterventionsfortheJustice-Involved:DuetothelimitedamountofresearchthatexplorestobaccocessationinterventionsinJIpopulations,andcommunitycorrectionsinparticular,thereisnotastandardsetofguidelinesorbestpracticesforinterventionsincorrectionalsettings(deAndrande&Kinner,2017).However,inthelastfewyearsresearchershaveincreasinglybeguntoexploremanypromisingcessationinterventionsfortheJI.Forinstance,theuseofMotivationalInterviewing(MI)orCognitiveBehavioralTherapy(CBT)inJIpopulationshasbeenfoundtoimprovesmokingabstinenceby6.6timescomparedwithacontrolgroup(Clarkeetal.,2013).PharmacotherapyforcessationisalsoeffectivewithintheJIpopulation(deAndrade&Kinner,2017).Infact,onestudyincommunitycorrectionsfoundthatthattheuseofpharmacotherapyalonecanresultinabstinenceratescomparabletoprovidingbothpharmacotherapyandcounseling(Cropseyetal.,2015).Overall,studieshavefoundthattheinterventionswiththegreatestefficacyinJIpopulationsarethosethatprovidecombinationtherapy,orbothbehavioralinterventionandpharmacotherapyforcessation(deAndrade&Kinner,2017;Jalalietal.,2015).Additionally,ithasbeenrecommendedthatcorrectional,medical,andmentalhealthprovidersshouldconstructcessationtreatmentplansforindividualspriortoreleasefromjailorprison(Binswanger,2011).Manyindividualswhohavebeenrecentlyreleasedfromjailorprisondonothaveaccesstoregularmedicalcareandhavedifficultynavigatingcomplicatedmedicalsystems.Alackofa“medicalhome”canmakethisevenmoredifficultfortheJI(Binswangeretal.,2011).Thesearesignificantstressorsthatmaymakeitdifficulttoaccesscessationprogramminginthecommunityandcancontributetotobaccorelapse.Inresponse,pre-releaseplanningcouldincreasethelikelihoodthatindividualswillfollowupwithprimarycareorotherprovidersandaccesscommunitycessationresources.Duringpre-releaseplanning,itmayalsobeusefultoassessanindividual’sintenttomaintainchangeoncereleased,sincepost-releaseintentionstosmokeareanextremelystrongindicatorforremainingtobaccofreeuponrelease(Thibodeauetal.,2010).Anindividual’sintentormotivationtoremaintobacco-freecouldbeimpactedbyinterventionsreceivedwhileincarcerated,suchastobaccocessationgroupsorpre-releaseplanning.RecommendedTreatmentModels:Thereareseveralmodelsthatholdpromiseforeffectivelystructuringtobaccocessationincorrectionssystems.TheSequentialInterceptandPatientCenteredMedicalNeighborhood

10

Modelsarepresentedasameansforidentifyingpointsofintervention.The5Asand2As-RModelsarethenpresentedasaframeworkfortobaccocessationserviceswithinanygivenservicesettingorcommunityhubofcare.SequentialInterceptModel:TheSequentialIntercept(SI)Modelprovidesaconceptualframeworkforcollaborationbetweenthecriminaljusticeandothertreatmentsystemstomethodicallyaddressandreducecriminalizationandrecidivism.Themodeldepictsthewaysinwhichpeopletypicallymovethroughthecriminaljusticesystemandsuggestsaseriesof"pointsofinterception,"oropportunitiesforintervening.Thus,theSImodelcanhelptoidentifypointsofinterventionforMaricopaCounty’stobaccocessationandwholehealthprogramming.ResearchsuggeststhattobaccocessationinterventionsareintegratedbestwithinIntercept3:Jails/Courts,specificallyuponentryintoprisonsorothercommunitycorrectionsprogramming,aswellasIntercept4:Reentry(Kauffman,2011).However,researchalsohighlightstheneedforcontinuedcessationsupportsforJIindividualswhentheyhavereturnedthecommunityandareparticipatingincommunitycorrectionsprogrammingduringIntercept5:CommunityCorrections(deAndrade&Kinner,2017).

11

ThePatient-CenteredMedicalNeighborhood:The“patient-centeredmedicalhome”suggeststhataprimarycareagencyshouldserveasthehubofhealthcareandpointofreferralforotherservices.Yet,fortheJIpopulation,theexpanded“patient-centeredmedicalneighborhood”(PCMN)isamorerealistic,compelling,andpragmaticmodel.AlthoughthePCMNincludesprimarycare,italsoincorporatesanetworkofagenciesthatservetheJIpopulation’swholehealth(Tayloretal.,2011).Thisnetworkoftenincludes,butisnotlimitedto:criminaljustice,socialserviceagencies,communityhospitals,specialtymedicaloffices,pharmaciesandlaboratories,housing,andstateandlocalpublichealthdepartments.ThecoreofthePMCNmodeliscommunity-basedintegrationandsystemredesignthatpromotespopulationhealth.Unlikethepatient-centeredmedicalhome,withinthePCMNanypointofservicemaybecomethehubofcare.ThePCMNallowsforacontinuityofcaremodeltointegratecountypublichealthprogramsandtheirexpansivecommunityconnections.Therefore,thePCMNmodelassumesthatmultipleprofessionalsworktowardthecommongoalofcommunityhealth.Fordecades,manyhealthprofessionalshaveworkedinsilosandfailedtoadequatelycommunicateorcollaboratewithotherproviders,oftenattheexpenseofqualitycare.Thisisparticularlytrueforindividualswhohavebeenrecentlyreleasedfromjailorprison.TheseJIindividualscommonlyhavedifficultynavigatingcomplicatedmedicalsystemsorlackaccesstoregularmedicalcare.Studieshaveshownthatafterreleasefromjailorprison,only15%ofinmatesareestimatedtohavehealthinsurance,andindividualsrecentlyreleasedfromcorrectionalfacilitiesreportthatlackofaccesstohealthcareleadstosignificantinstabilityatreentry(Burgess-Allenetal.,2006;Seal,2007).Lackofa“medicalhome”canmakethisevenmoredifficult(Binswangeretal.,2011).Inresponse,thecoretenetsofthePCMNmodeladdressthesedeficitsandprovidetheframeworkforinnovativeservicedeliveryfortheJIpopulation.The5AsModel:Only40%-76%ofgeneralpopulationpatientsreportthattheirphysiciansaskaboutsmokingandadvisethemtoquit(e.g.,Huetal.,2003;Kaplanetal.,2016;Parketal.,2015).Advicetoquitwasgivensignificantlylessoftentorespondentsclassifiedaslesseducated(42.3%),ortopatientswithalowerfamilyincome(43.5%)wholiveoutsidethenortheast(Kaplanetal.,2016).Forallsmokers,advicetoquitistypicallynotfollowedbyassessment,brieftreatment,appropriatereferrals,orfollow-up(Conroyetal.,2005;Morris,MillerandMahalik,2011).Ratesofprovidingcounselingorpharmacotherapyarebelow20%(DePueetal.,2002;Longoetal.,2006;Parketal.,2015).The5AsModeldirectsprovidersandstafftoscreenfortobaccouse(ASK),torecommendreducingorstoppinguse(ADVISE),toevaluate(ASSESS)bothsmokers’willingnesstoquitandlevelofnicotinedependence,toofferaid(ASSIST)tohelpintheirquitattempt,andthentoset(ARRANGE)follow-upvisits(Fioreetal.,2008).Utilizingthe5AsModelhelpstoensure

12

treatmentconsistency.The5AsModelisalsoadvantageoustothecriminaljusticesystem,asthemodelmaybemodifiedtocomplementcommonbehavioralhealthandintegratedcareassessment,screening,treatment,andreferralpractices.2As-RModel:Similartothe5AsModel,the2As-RModelprovidesashortenedinterventiontobeusedwhenproviderscannotprovideallneededcessationservices.The2As-RModeldirectsprovidersandstafftoscreenfortobaccouse(ASK),torecommendstoppingtobaccouse(ADVISE)andtoreferpatientsorclientstoadditionalservices(REFER).Aswiththe5AsModel,the2As-RModelensurestreatmentconsistency.Tobacco-FreePoliciesinCorrectionalSystems:Tobacco-freepoliciesarecurrentlytheprimaryformofpreventiveinterventiondeployedincorrectionalsystems(Cork,2012).Tobacco-freepolicieswithincorrectionalsettingsrangefromlimitedindoorsmokingbanstocomprehensivecampus(indoor/outdoor)tobaccobans.Tobacco-freepoliciessignificantlyreduceconcentrationsofsecondhandsmokewithinjailsandprisons(Proescholdbelletal.,2008)andreducesmoking-relatedmortality(Binswangeretal.,2014).Therearedistinctdifferences,however,betweenfacilitiesthatadoptanindoorsmokingbanversusacomprehensivecampustobaccoban.Researchdemonstratesthatindoorsmokingbansalonedolittletopromotesmokingcessation(Kauffmanetal.,2011).Whileindoorsmokingbansdocontributetoareductioninthenumberofcigarettesconsumedperday,thenumberofsmokerscanstillincreaseunderanindoorsmokingban(Kauffmanetal.,2011).Inaddition,one2015literaturereviewfoundthatbetween20%-76%ofinmatesreportnoncompliancewithsuchtobacco-freepolicies(Kennedy,Davis,&Thorne,2015).Therefore,indoorsmokingbansmaynotbeenoughtoreduceoreliminatesecondhandsmokeexposurewithincorrectionalfacilities(Lasnieretal.,2011).Comparedtoanindoortobaccoban,acampus(indoor/outdoor)tobaccobanmayfurtherreducedailysmokingandsecondhandsmokeexposureincorrectionalfacilities.Forinstance,onestudyfoundthat64%ofinmatesinastateprisonreporteddailysmokingunderanindoorsmokingban,versusonly42%ofinmatesinanotherstateprisonthatintroducedacampussmokingban(Proescholdbelletal.,2008).However,researchalsodemonstratesthatevencampustobacco-freepoliciesarenotsufficienttopromotecessationwithinJIpopulations.Infact,mostJIindividualsreleasedtothecommunityquicklyrelapsetosmoking.Strikingly,studiesshowthatupto97%offormerinmatesrelapsebacktosmokingwithinsixmonthsoftheirreleasebacktothecommunity(Lincolnetal.,2009).Undertobacco-freepolicies,individualswhocontinuetousetobaccoproducts(andthereforeprolongwithdrawalsymptoms)reporthighlevelsofdistresscomparedtothosewhoceasetousetobaccoundersuchbans(Cropsey&Kristeller,2005).Toimprovetheefficacyofsmokingbansinpromotingtobaccocessation,itisrecommendedthatjailsandprisonsreviewtheproductsthataresoldintheircommissary(Greenbackeretal.,2017).Ideally,tobaccoproducts

13

wouldberemovedfromcommissariesundertobaccobans.However,forjailsandprisonsthatcontinuetopermittobaccouseoutdoors,studieshavefoundthatthetypeofproductssoldincommissariesmayimpacttheamountofcigarettesthatindividualssmoke.Decreasesintobaccousehavebeenfoundtobegreaterwithininstitutionsthatonlysellultra-lightmanufacturedcigarettes,comparedtoinstitutionswherelessexpensive,unfiltered,hand-rolledcigaretteswereavailableforpurchase(Kauffmanetal.,2011).Theefficacyoftobacco-freepoliciescanalsobeimprovedthroughconsistentenforcement.Problemswithtobacco-freepolicieswithincorrectionalsettingstendtoberelatedtolaxorinconsistentenforcementaswellastheunequaltreatmentofstaffandinmates(Cork,2012).Facilitiesthatproperlyenforcetobacco-freepoliciesseegreaterreductionsinsecondhandsmokeexposure(Proescholdbelletal.,2008).Incomparison,atobacco-freepolicyinacorrectionalsettingmaybeunderminedifexemptionspermitsmokingindesignatedareasor,alternatively,ifstaffmembers–butnotJIindividuals–areallowedtocontinuetobaccouse.Suchpoliciesarecommon;oneCanadianstudyfoundthatamongprisonsandjailsthatreportedthattheywere“tobacco-free,”79%permittedtheuseoftobaccobystaff(Chavezetal.,2011).Withinsuchsituations,researchsuggeststhatitislikelythatmembersoftheprisonstaffprovidethetobaccoproductsusedbytheJIincorrectionalfacilities(Foleyetal.,2010).Accordingly,tobacco-freepoliciesshouldbeenforcedforbothcorrectionalstaffmembersandtheJI.Anotherissuewithsmoke-freepoliciesincludesthedevelopmentofblackmarketsfortobaccoproducts,whichsomefearedcouldincreaseviolentbehaviorwithinincarceratedpopulations(Cork,2012;Macaskill&Hayton,2007).However,despiteearlyconcern,therehasbeenlittleevidencethatbanningtobaccouseinjailsandprisonscontributestoanincreaseinviolentbehavioramonginmates(Kennedyetal.,2015).Inconclusion,toreducetheprevalenceoftobaccouseincorrectionalsettingsandfortheJI,campussmokingbansshouldbeimplemented,andaremuchmoreeffectivewhenaccompaniedbyprovencessationservices(Cork,2012;Kennedyetal.,2015;Proescholdbelletal.,2008).Counseling/BehavioralInterventionsforTobaccoCessationinJIPopulations:MotivationalInterviewing(MI):MIisanempiricallydevelopedstyleofcommunicationthatemphasizestheevocationandreinforcementofintrinsicmotivation(changetalk)withinacompassionate,collaborative,andsupportiverelationship(Miller&Rollnick,2013).UtilizingbriefMI,non-judgmental,open-endedreflectiveresponses,affirmations,andwell-timedsummaries,servestomirrorandreinforceself-efficacyandhealthybehaviorchange.Meta-analyseshavefoundMItobeeffectiveincomparisontono-treatment,writtenmaterials,andnon-specifictreatment(Hettemaetal.,2010;Lundahletal.,2010).MIhasbeenproveneffectivefortobaccocessationacrossawidespectrumofhealthcareandpublicservicesectors(Laietal.,2010;Burkeetal.,2003).

14

MIhashadsubstantialnationaluptakeincorrectionalsystems(USDept.ofJustice,2016).WhiletherearebothprosandconsassociatedwiththeuseofMIwithincorrectionalprogramming,studieshavefoundMItobeeffectiveinworkingwiththecriminaljusticepopulation(Noonan,2012;Bradford&Nandi,2012).Forexample,onestudyfoundthatMIfortobaccocessationincreasedprisonercessationattemptsandhelpedinmatestoachieveashort-termreductioninsmokingdays(Jalalietal.,2015).MImayalsobemoreappropriatethanothermethodsofbehavioralinterventionforJIindividualswhoarenotyetreadytomakeabehaviorchange(vandenBergetal.,2016).Inaddition,theabilityofMItoincreaseindividualinterestinquittingisimportantinjailsandprisonswithtobacco-freecampuses,whereindividualsmaynothavetheabilitytoengageinorpracticecognitivebehavioralstrategies(Clarkeetal.,2011).MIcanbeutilizedatnearlyeverypointinthecorrectionalcasemanagementprocessandcanbeappliedinvariouswaystotobaccocessation.MIcanbeusedtogatherdetailedinformationabouttobaccouse,toreduceresistancetotobaccointerventions,andtoprovideastructureforadvancingbehaviorchange.Additionally,MIcanhelpinmatestoincreaseindividualinterestinremainingsmoke-freepost-release(Clarkeetal.,2011).Sincepost-releaseintentionstosmokewereanextremelystrongindicatorforremainingtobaccofree(Thibodeauetal.,2010),MIislikelytoimprovelong-termabstinencerates.WithintheJIpopulation,studieshavefoundthatindividualinterestinquittingtobaccouseistypicallyrelatedtofeelinggenerallybetter,improvementsinoverallhealth,increasesininexercisetolerance,theacknowledgementofstress,andtheabilitytotastefood(MacAskill&Hayton,2007;Muir,2016).Basedonthesethemes,MImayofferanimportantopportunitytoeasilyintegratetobaccocessationwithinotherwhole-healthprogrammingandtotailortobaccoprogrammingspecificallyfortheJIpopulation.CognitiveBehavioralStrategies:Inthegeneralpopulation,thereisconsistentevidencethatmoreintensivecognitivebehavioralcounseling(sessiondurationlastingmorethan20minutes)andhighernumbersofcounselingsessionsrelatetoincreasedabstinencefromsmoking(Fiore&Baker,2011).Researchshowsastrongrelationshipbetweenthelengthoftimespentinperson-to-personcontactandsuccessfultreatmentoutcomes.Minimalcounseling(definedaslessthan3minutes)isassociatedwithabstinenceratesaround13.4%.Incomparison,low-intensitycounseling(definedbetween3-10minutes)andhighintensitycounseling(definedasmorethan10minutes),haveassociatedabstinenceratesof16%and22.1%,respectively(Fioreetal.,2008).Moreover,multipletreatmentsessionsincreasetobaccoabstinenceratescomparedtooneornosessions.Estimatedabstinenceratesfor0-1sessionsis12.4%,2-3sessionsis16.3%,4-8sessionsis20.9%and>8sessionsis24.7%(Fioreetal.,2008).AccordingtotheClinicalPracticeGuideline,thecognitiveandbehavioralinterventionswiththehighestabstinenceratesareskillsbuilding/problemsolvingandsupport/encouragement(Fioreetal.,2008).Skillsbuildingandproblemsolvingmayincludelearningtoidentifyhigh-risksituationsorsituationsthattriggeranindividual’ssmokingbehavior,andpracticingassociated

15

copingskills.Supportandencouragementmayincludeprovidingpsychoeducationaroundtobaccocessationstrategiesorstatistics.Cognitivebehavioralstrategiesshouldaddresscorrections-specificissuessuchasboredom,stress,andtransferorreentry(Richmondetal.,2006).Consistentwithguidanceforthegeneralpopulation,morethantwocognitivebehavioralsessionshavebeenrecommendedforworkingwiththeJI(Richmondetal.,2006).Itisalsoimportanttorecognizethepossibilitythatcognitivebehavioralstrategiesmaynotbeequallyeffectivewithinallcorrectionalsettings;Clarkeetal.,(2013)suggeststhatcognitivebehavioralstrategiesmaynotbeasapplicableforincarceratedpopulationsheldincorrectionalsettingswithcampustobacco-freepolicieswheretheJIcannotactivelypracticecessationstrategies.Insuchcorrectionalsettings,itissuggestedthatcognitivestrategiesbecombinedwithMItoimproveinterventionefficacy.Tobacco-FreeGroups:Groupinterventionsareanimportantcounselingmodalityusedtohelpmotivateindividualstochange.Tobacco-freegroupsofferaneffectiveinterventiontopromoteandtoachievetobaccocessation.Tobacco-freegroupshavebeenfoundtohaveassociatedquitratesbetween7-13%withinthegeneralpopulation(Fioreetal.,2008).Tobacco-freegroupshavealsoshownpromisingresultswithintheJIpopulation(Cropseyetal.,2008;Garver-Apgaretal.,2017).Forexample,a2017studyevaluatingtobacco-freegroupsimplementedwithinprobation,parole,anddrugcourtunitsinArkansasfoundthat39%oftheentiresample(n=962)reportedatleastonequitattemptduringtheirgroupattendance(Garver-Apgaretal.,2017).Forthosewhoattendedthefull6-sessioncurriculum,49%reportedatleastonequitattemptand5%reportednotobaccouse.Inaddition,betweensession1andsession6,thenumberoftobaccouserswhoreportedusingtobaccomorethan11timesperdaydecreased.Thisdecreaseindicatesanincreasedlikelihoodthattheseindividualswillbecapableofquittingtobaccouseinthefuture(Broms,Korhonen&Kaprio,2008).Finally,theevaluatorsfoundthatattendingjustthreegroupsessionscontributedtoreducedtobaccouse.Giventhat59%ofthesampleattendedatleastthreegroupsessions,amajorityofparticipantsweredeterminedtohaveattendedenoughsessionstoreceivesometherapeuticbenefit(Garver-Apgaretal.,2017).Anotherstudyinstituteda10-weekgroupintervention,alongwithNRT,towomeninaU.S.correctionalfacility(Cropseyetal.,2008).Attheendoftheintervention,18%ofparticipantshadquittobaccouse.Atsixmonths,14%ofparticipantshadremainedabstinent,comparedtoonlyabout3%ofthecontrolgroup.TherearesomecaveatstoconsiderwhenworkingwiththeJIpopulation:individualtreatmentisrecommendedforthosewhoself-harm,thosewhoaredeterminedtobementallyunstable,individualswhoaredisruptiveorlackself-esteem,andhighlyintelligentindividuals(DepartmentofHealthandHMPrisonService,2003).

16

Co-occurringTreatment:Researchindicatesthatcomprehensivetreatmentprogramsforincarceratedindividualswithco-occurringmentalhealthandsubstanceusedisorderscansignificantlyreducerecidivism,andthattheadditionofcommunityreentryservicescanaugmentthesepositiveoutcomes(Lurigio,2011;Petersetal.,2012;Sacksetal.,2004).Researchalsodemonstratesthatindividualswhotreattheiraddictiontotobaccoandothersubstancesatthesametimeare25%morelikelytosustaintheirrecoverythanindividualswhodonotaddresstobaccowhileinrecoveryfromotherdrugs(Prochaska,Gill,&Hall,2004).Therefore,co-occurringtreatmentpresentsanadvantageousopportunityforeffectivelyaddressingtobaccocessationwithincommunitycorrectionalsystems.Ratherthanbuilding“siloed”tobaccocessationtreatment,theseactivitiescanbeembeddedwithinindividualandgroupcounselingthatisalreadyoccurring.Asanexample,tobaccodependencehasoftenbeenperceivedasseparatefromotheralcoholanddruguse,butthecorebehavioraltreatmentsaretypicallythesame.Treatmentapproachesthatconcurrentlyaddressmentalhealthandsubstanceusedisorders,suchasMI,trauma-informedcare,andcognitivebehavioraltherapies,areequallyapplicabletotobaccodependence(Lurigio,2011;Petersetal.,2012).AParallelProcess:Whileoftenoverlooked,ahighpercentageofcriminaljusticeemployeesincourts,jails,andcommunityservicesettingsaretobaccousers.Relatedly,correctionsstaffoftenpossessnegativeattitudestowardtobaccocessationservices(MacAskill&Hayton,2007).Thesenegativestaffattitudestowardstobaccocessationandtobacco-freepoliciescanresultinlaxtobacco-freepolicyenforcement(Cork,2012).Onecriticalmeansofovercomingpotentialstaffbiastowardtobacco-freepolicyenforcementandtheprovisionoftreatmenttotheJIistooffertobaccocessationresourcesandsupporttocorrectionalstaffwhosmoke(Cork,2012).PharmacotherapyforTobaccoCessationinJIPopulations:Whenpeoplestopusingtobaccoproductsandtheamountofnicotineintheirbodydecreases,theyexperiencewithdrawalsymptoms.Withdrawalsymptomscanmakepeoplesouncomfortablethattheyoftenrelapseandbegintouseagain.Cessationmedicationshelptoalleviatenicotinewithdrawal,mimictheeffectsofnicotine,andblocktheeffectsofnicotine.Therefore,cessationmedicationshelpmakepeoplemorecomfortablewhiletheyareworkingtochangetheirsmokingbehaviororhabit.Theuseofpharmacotherapyincreasesthelikelihoodoftobaccocessationinthegeneralpopulation(Fioreetal.,2018).TheuseofpharmacotherapyhasalsobeenproventobeeffectivewithintheJIpopulation.Infact,arecentsystemicreviewofstudiesinvolvingcessationinterventionsforincarceratedadultsand/orprisonstafffoundthatcessationinterventionsthatincludeapharmacologicalcomponentareparticularlyeffective(deAndrade&Kinner,2017).Similarly,studieshavefoundthatNRTcombinedwithMIismoreeffectivethanMIaloneinaJIpopulation(Jalalietal.,2015),andNRTalonecanproduceanabstinenceratecomparabletocounselingandNRTcombined(Cropseyetal.,2015).Moreover,themajorityofJIindividualsin

17

communitycorrectionsareinterestedinpharmacotherapyfortobaccocessation(Cropseyetal.,2010).TherearecurrentlysevencessationmedicationsapprovedbytheFoodandDrugAdministration(FDA).Thesemedicationsincludenicotinegum,nicotinelozenge,nicotinepatch,nicotinenasalspray,nicotineinhaler,bupropionSRtablets(Zyban),andvareniclinetablets(Chantix).Cessationmedicationsthatareavailablewithoutaprescriptionincludenicotinegum,lozenges,andpatches.Currently,themostcommonformsofpharmacotherapyusedforcessationinterventionswithintheJIpopulationincludethenicotinepatchandbupropion.Thenicotinepatchisaconvenientchoicesinceitdeliversrelativelyhigherlevelsofnicotineoverasustainedperiodoftime.Asaresult,thenicotinepatchonlyneedstobeappliedonceperday.Incomparison,giventhehighprevalenceofbehavioralhealthconditionsamongtheJI,bupropionhasbeenselectedforsomestudiesbecauseofbothitsanti-depressanteffectsandbecausethereisagenericversionavailable(Cropseyetal.,2015).However,theuseofanti-depressantsforsmokingcessationinjailsandprisonsmaybeunfeasible(Cropseyetal.,2008).WhilethereissomeconcernthatNRTandothercessationmedicationsmaybecontraindicatedwithintheJIpopulation(Maurer,2014),NRTisasafemedicationwithtypicallyfewsideeffects.TherearenointeractionsbetweenNRTandpsychiatricmedications.AlthoughtheconcomitantuseofbupropionandNRTfortobaccocessationmayincreaseriskforhypertension,theFDAstillapprovescombinationtherapywithbupropionandNRT.NRTcanbeusedsafelybyindividualswithstablecardiovasculardisease,butshouldnotbeusedwithintwoweeksofaheartattackoriftheindividualhasaseriousarrhythmiaorsevereorworseningangina(Ferguson,Shiffman,&Gitchell,2011;Mooreetal.,2009).Additionally,thereissomeconcernthatmanyoftheJIwithincorrectionalfacilitiespoliciesmaynotmeetthegeneralmedicalcriteriaforcessationpharmacotherapy(Maurer,2014).Pharmacotherapyisintendedtobeusedtoinhibitorpreventnicotinewithdrawalsymptoms.Withdrawalsymptomstypicallysubsidebetween2-4weeksafterceasingtobaccouse(USDHHS,2004).Ifanindividualisheldwithinatobacco-freecorrectionalfacilityformorethanamonth,itispossiblethattheirwithdrawalsymptomswillhavealreadysubsided;inthesecases,theuseofpharmacotherapymaynotbeeffective(Clarkeetal.,2011).However,giventhefactthattobacco-freepoliciesarenotalwayswellenforcedincorrectionalsettings,individuals’withdrawalsymptomsmaynotsubsideduringincarceration(Cork,2012).Additionally,knowledgeofandfamiliaritywithNRTmayhelpindividualstofeelconfidentintheirabilitytoremaintobacco-freeuponreleaseintothecommunity.OtherpotentialissuesaroundNRTincorrectionssettingsmayincludethemisuseofNRT,challengestoaccessingNRTduetojail/prisontransfersandreentry(Richmondetal.,2006),andthepossibledevelopmentofNRTblackmarkets(MacAskill&Hayton,2007).Toavoidsomeoftheseissues,onesmallstudywithinaprisonelectedtocoordinatethedailyadministrationnicotinepatches(Greenbackeretal.,2017).Withinthisstudy,NRTwasadministeredtotheentireparticipantcohortonceperdayattheprisonpharmacy.However,therearecurrentlyno

18

knownbestpracticesorrecommendationsaroundpharmacotherapyadministrationincorrectionalsettings.DespiteJIinterestinNRT(Cropseyetal.,2010),NRTandothercessationpharmacotherapycanbedifficultfortheJItoaccess.Whensoldinjailsandprisonsincommissaries,nicotinegumcancostmorethanwhataprisonercanearninasinglemonth(Kauffmanetal.,2011).Moreover,aboxofnicotinepatchescancostmorethan15timeswhatischargedforasinglepackofcigarettes(Kauffmanetal.,2011).Evenwithinthecommunity,accessingNRTcanbechallengingfortheJI.Oneinterventionthatevaluatedtheefficacyoftobacco-freegroupsforindividualsonprobationandparolefoundthatlessthan4%ofparticipantsaccessedNRTduringtheintervention(Garver-Apgaretal.,2017).Moreover,evenwhenNRTpricesaresubsidized,theJIareunlikelytoaccessNRT.Forexample,onestudyinAustraliafoundthat,despitegovernmentsubsidedprices,only86ofthe971individualsthestudytrackedafterreleasefromprisonaccessedsomeformofNRTorpharmacotherapy(Puljevícetal.,2017).AdherencetocessationmedicationcanalsobeproblematicwithintheJIpopulation(Cropseyetal.,2015;Turan&Turan,2016).ThisistruebothwhenJIindividualspayfortheirownpharmacotherapy(Turan&Turan,2016)aswellaswhentheyreceivemedicationforfree(Cropseyetal.,2015).Medicationadherenceissignificantlyrelatedtocessation(Cropseyetal.,2008;Jalali,2015),butstudiesshowthatwithoutadditionalinterventiononlyaround50%ofJIindividualswhoreceivefreepharmacotherapythroughcessationinterventionsaremedication-adherent(Cropseyetal.,2015;Cropseyetal.,2008).IndividualsareoftenunsuccessfulwithNRTordiscontinueitsusebecausetheydonotknowhowtodoseoradministerNRTproperly.ThisislikelytrueoftheJIpopulationaswellasthegeneralpopulation.However,preliminaryresearchdemonstratesthatNRTcounselinginJIpopulations,specifically“invivo”samplingofNRT,increasesbothmedicationadherenceandthelikelihoodofcessation(Cropseyetal.,2017).“Invivo”samplingallowsindividualstotryvariousformsofcessationmedicationsforrelativelyshortperiods.Forinstance,onerecentstudybyCropseyetal.(2017)implementedan“invivo”interventionthatincludedfour30-minutecounselingsessions.Duringeachsession,individualswereinstructedonhowtouseaspecificformofNRT(bothnicotinegumandthenicotinepatch)andthensampledthisNRTinthepresenceofacounselor.ThetimingofthesessionwasdesignedtoallowJIindividualstobegintoexperiencetheeffectsoftheNRTbeforethesessionconcluded.Importantly,thisstudydemonstratedtheabilityof“invivo”samplingtoincreasemedicationadherenceandefficacyamongtheJI.Additionally,thestudyreinforcedthefeasibilityofproviding“invivo”samplingamongtheJI;abachelor’slevelstudentresearchassistantwithjusttwohoursoftrainingprovidedtherequiredNRTcounseling(Cropseyetal.,2017).Therefore,whileaspecializedindividualsuchasaTobaccoTreatmentSpecialist(TTS)coulddeliverthistypeofintervention,itmayalsobefeasibletoexploretheuseofnon-specialtytrainedindividualslikepeers.Pharmacotherapycanbeexpensive,anditsprovisionwithincorrectionalsystemsisresource-contingent.However,wherepossible,itisrecommendedthatNRTandothercessationmedicationsareofferedforfreetotheJI(deAndrade&Kinner,2017).Researchalsosuggests

19

thatprovidingNRTforanextendedperiod(atleast8-10weeks),beginningwithahigherdoseofnicotineandtailoringthedosedownovertime,mayimproveinterventionefficacy(Cropseyetal.,2017;Cropseyetal.,2008;Greenbackeretal.,2017;Richmondetal.,2006).TelephonicCessationServices–TheASHLine:AllU.S.statesprovidetelephoniccessationservices,or“quitlines”.Withinthegeneralpopulation,quitlinecounselingcanmorethandoubleasmoker’schancesofquitting,andquitlinecounselingcombinedwithmedicationcanmorethantriplethechancesofquitting(Anderson&Zhu,2007;Stead,Perera,&Lancaster,2007).Quitlinesalsohavethepotentialtoovercomecommonbarrierstohealthcareaccesssuchaslackoftransportationaswellasthecostofbothcounselingandcessationmedications(Zhuetal.,2000).However,fartoofewsmokersavailthemselvesofthisservicedespitemediacampaignstargetingsocio-economicallydisadvantagedpopulations.Lessthan1%ofallsmokersintheU.S.accesscounselingormedicationassistancethroughquitlines(NorthAmericanQuitlineConsortium,2015).QuitlineservicescurrentlyhavelimitedreachfortheJIpopulation.However,researchersarebeginningtoexplorethewaysinwhichquitlineservicescanbetailoredtomeettheneedsofJIpopulations.Forinstance,Greenbackeretal.(2017)workedwiththequitlineinPennsylvaniatotailorservicestotheJIpopulation.Thisworkincludedreviewingthequitlineintakeproceduretoeliminatequestionsthatwerenotapplicabletoindividualsincorrectionalsettings,suchasinquiringaboutemploymentsituation,publichousing,andinterestintextmessagesupport.JIindividualsinthisinterventionwerealsoassignedtoworkwithadesignatedquitlinecoach.DesignatedcoachesfortheJImayovercomebarrierstotelephonicservicessuchasrestrictionsoncalltimesincorrectionalsettings(inthisexample,participantswerelimitedtofive20-minutecalls)oralimitednumberofphoneminutes.Furthermore,designatedcoachescanbetrainedtotailorcounselingtotheJIpopulation,ensuringthatthecopingtechniquesandresourcesprovidedareappropriateforandapplicabletotheJI(Greenbackeretal.,2017).InArizona,theASHLineprovidesquitlineservicesforthestate,including12weeksoffreeQuitCoachingand,foreligibleindividuals,4weeksoffreenicotinegum,patches,orlozenges.TheASHLinecanbereachedbycalling1-800-556-6222orbytexting“NOSMOKE”to74079.TobaccoTreatmentSpecialists:TobaccoTreatmentSpecialists(TTS)arevaluableresourceswhocanofferspecializedinterventiontotreattobaccouseanddependence.AccordingtotheCouncilforTobaccoTreatmentTrainingPrograms(CTTTP),CertifiedTobaccoTreatmentSpecialists(CTTS):

1. Understandthesciencebehindtobaccoaddiction,nicotinewithdrawalsymptoms,andeffectivetreatmentsfortobaccouse

2. Provideclearandaccurateinformationaboutthecausesandconsequencesoftobaccouse

20

3. Developindividualizedtreatmentplansusingcomprehensive,evidence-basedassessmentsandtreatmentstrategiesincluding:

a) Clearandaccurateinformationabouteffectivemedicationsb) Effective,practical,cognitive-behavioralstrategiesforquittingandstayingquit

4. Provideeffectivetreatmentforallformsoftobaccoandnicotineuse5. Workwithavarietyofspecificpopulationsincludingthosewithspecifichealthissues6. Usespecific,well-acceptedmethodsfortrackingindividualprogress,recordkeeping,

programdocumentation,outcomemeasurement,andreporting7. Serveaseducationalresourcesfororganizations,healthcareproviders,andthegeneral

publicregardingtobaccousetreatmentissuesTTStrainingisofferedbytrainingprogramsaccreditedthroughCTTTP.AllTTSprogramsmustmeettheCoreCompetenciesestablishedbytheAssociationfortheTreatmentofTobaccoUseandDependence(ATTUD).KeypersonnelincorrectionssettingswhoreceiveCTTStrainingwillpossesstheknowledgeandskillsetstofacilitatemodelssuchasthe5As,overseebehavioralandpharmacologicalinterventions,andprovidetrainingtootherprovidersandtheagencyasawhole.Conclusion:ThecorrectionssystemhasanessentialroleinthecontinuityofcareneededtohelpJIindividualsquittobaccouseandmaintainlong-termabstinence.ThemajorityofJIindividualswanthelpquitting,andthereisgrowingsupportamongcorrectionsleadershipregardingofferingtobaccocessationserviceswhileindividualsareinthecorrectionssystem.Whiletherearehistoricalbarrierstocareandrealisticresourceandworkflowconsiderations,amountingevidencebasefindsthattobacco-freepoliciesandcessationservicesarefeasible.Importantly,suchinterventionsareoftenlow-burdenadditionstohealthcareandbehavioralhealthtreatmentcurrentlyprovidedbythecorrectionssystem.Thisreportprovidesbothbackgroundandguidanceforeffectivelyidentifyingpointsofintervention,establishingtreatmentframeworks,andofferingbothbehavioralandpharmacologicalservices.

21

IV.WorksCitedAmericanNonsmokers’RightsFoundation(2012).100%SmokefreeandTobaccoFreeCorrectionalFacilities.Retrievedfromhttp://www.no-smoke.org/pdf/100smokefreeprisons.pdfAnderson,C.M.,&Zhu,S.H.(2007).Tobaccoquitlines:lookingbackandlookingahead.TobControl,16:181-186.Andrews,D.A.,&Bonta,J.(2010).Rehabilitatingcriminaljusticepolicyandpractice.Psychology,PublicPolicy,andLaw,16(1),39.Annamalai,A.,Singh,N.,&O’Malley,S.(2015).SmokingUseandCessationAmongPeoplewithSeriousMentalIllness.YaleJournalofBiologyandMedicine,88(3):271-277.Ashcroft,L.&Anthony,W.A.(2011).Prisonersthrivewithpeersupporttraining.BehavioralHealthcare,20–22.Barbeau,E.M.,Krieger,N.,&Soobader,M.J.(2004).Workingclassmatters:socioeconomicdisadvantage,race/ethnicity,gender,andsmokinginNHIS2000.AmJPublicHealth,94(2),269-278.Benowitz,N.L.(2008).Neurobiologyofnicotineaddiction:Implicationsforsmokingcessationtreatment.AmericanJournalofMedicine,121(4),3.�Binswanger,I.A.,Krueger,P.M.,&Steiner,J.F.(2009).PrevalenceofchronicmedicalconditionsamongjailandprisoninmatesintheUSAcomparedwiththegeneralpopulation.JournalofEpidemiologyandCommunityHealth,63,912-919.Binswanger,I.A.,Nowels,C.,Corsi,K.F.,Long,J.,Booth,�R.E.,Kutner,J.,&Steiner,J.F.(2011).“Fromtheprisondoorrighttothesidewalk,everythingwentdownhill,”Aqualitativestudyofthehealthexperiencesofrecentlyreleasedinmates.InternationalJournalofLawandPsychiatry,34(4),249-255.Binswanger,I.A.,Stern,M.F.,Deyo,R.A.,Heagerty,P.J.,Cheadle,A.,Elmore,J.G.,&Koepsell,T.D.(2007).Releasefromprison—Ahighriskofdeathforformerinmates.NewEnglandJournalofMedicine,356(2),157-165.Broms,U.,Korhonen,T.,&Kaprio,J.(2008).Smokingreductionpredictscessation:LongitudinalevidencefromtheFinnishadulttwincohort.Nicotine&TobaccoResearch,10,423–427.Bradford,B.,&Nandi,A.(2012).Motivationalinterviewingincorrections:AcomprehensiveguidetoimplementingMIincorrections.PreparedfortheUnitedStatesDepartmentofJusticeandtheNationalInstituteofCorrections.Retrievedfromhttp://static.nicic.gov/Library/025556.pdfBureauofJusticeStatistics.(2015).“CorrectionsPopulationintheUnitedStates,2015”https://www.bjs.gov/index.cfm?ty=pbdetail&iid=5870

22

BureauofPublicHealthService(PHS)(2008).ClinicalPracticeGuidelineforTreatingTobaccoUseandDependence.Retrievedfrom:https://bphc.hrsa.gov/buckets/treatingtobacco.pdfBurgess-Allen,J.,Langlois,M.,Whittaker,P.,(2006).Thehealthneedsofex-prisonersimplicationsforsuccessfulresettlement:aqualitativestudy.InternationalJournalofPrisonerHealth,2,291–301.Burke,B.L.,Arkowitz,H.,&Menchola,M.(2003).Theefficacyofmotivationalinterviewing:ameta-analysisofcontrolledclinicaltrials.JournalofConsultingandClinicalPsychology,71(5),843-861CenterforDiseaseControlandPrevention[CDC].(2015).Currentcigarettesmokingamongadults–UnitedStates,2005-2014.MorbidityandMortalityWeeklyReport,64(44),1233-1240.CenterforSubstanceAbuseTreatment.(2009).WhatarePeerRecoverySupportServices?HHSPublication(SMA)09-4454.Rockville,MD:SubstanceAbuseandMentalHealthServicesAdministration,U.S.DepartmentofHealthandHumanServices.Retrievedfrom:https://store.samhsa.gov/shin/content/SMA09-4454/SMA09-4454.pdfChavezRS,Oto-KentDS,PorterJ,BrownK,QuirkL,LewisS.Tobaccopolicy,cessation,andeducationincorrectionalfacilities:NationalCommissiononCorrectionalHealthCareandNationalNetworkonTobaccoPreventionandPoverty.WestSacramento,CA:NationalNetworkonTobaccoPreventionandPovertyHealthEducationCouncil;2004.Clarke,J.G.,Martin,R.A.,Stein,L.,Lopes,C.E.,Mello,J.,Friedmann,P.,&Bock,B.(2011).WorkingInsideforSmokingElimination(ProjectW.I.S.E.)studydesignandrationaletopreventreturntosmokingafterreleasefromasmokefreeprison.BmcPublicHealth,11,767.Clarke,J.G.,Stein,L.A.,Martin,R.A.,Martin,S.A.,Parker,D.,Lopes,C.E.,McGovern,A.R.,Simon,R.,Roberts,M.,Friedman,P.,&Bock,B.(2013).Forcedsmokingabstinence:notenoughforsmokingcessation.JAMAInternMed,173(9):789-94.Conklin,T.J.,Lincoln,T.,&Tuthill,R.W.(2000).Selfreportedhealthandpriorhealthbehaviorsofnewlyadmittedcorrectionalinmates.AmericanJournalofPublicHealth,90(12),1939.Conroy,M.B.,Majchrzak,N.E.,Silverman,C.B.,Chang,Y.,Regan,S.,SchneiderL.I.,&Rigotti,N.A.(2005).Measuringprovideradherencetotobaccotreatmentguidelines:acomparisonofelectronicmedicalrecordreview,patientsurvey,andprovidersurvey.Nicotine&TobaccoResearch,7(1),35-43Cork,K.(2012).“TobaccoBehindBars:PolicyOptionsfortheAdultCorrectionalPopulation.”PublicHealthLawCenter.Retrievedfrom:http://publichealthlawcenter.org/sites/default/files/resources/phlc-policybrief-tobaccobehindbars-adultcorrections-2012.pdfCouncilonTobaccoTreatmentSpecialists.(n.d.)CertifiedTobaccoTreatmentSpecialists.Retrievedfromhttp://ctttp.org/wp-content/uploads/2015/06/What-is-a-TTS-2011_12_1.pdf.Cropsey,K.L.,Clark,C.B.,Zhang,X.,Hendricks,P.S.,Jardin,B.F.,&Lahti,A.C.(2015).RaceandMedicationAdherenceModerateCessationOutcomesinCriminalJusticeSmokers.AmJPrevMed,49(3):335-44

23

Cropsey,K.,Eldridge,G.,Weaver,M.,Stizer,M.,Vilalobos,G.,&Best,A.(2008).SmokingCessationInterventionforFemalePrisoners:AddressinganUrgentPublicHealthNeed.AmericanJournalofPublicHealth,99(10):1894-1901.Cropsey,K.L.,Hendricks,P.S.,Schiavon,S.,Sellers,A.,Froelich,M.,Shelton,R.C.,&Carptenter,M.J.(2017).APilotTrialofInvivoNRTsamplingtoincreasemedicationadherenceincommunitycorrectionssmokers.AddictiveBehaviors,67:92-99.Cropsey,K.,Jones-Whaley,S.,Jackson,D.,&Hale,G.(2009).Smokingcharacteristicsofcommunitycorrectionsclients.Nicotine&TobaccoResearch,12(1),53-58.CropseyKL,KristellerJL.(2005).Theeffectsofaprisonsmokingbanonsmokingbehaviorandwithdrawalsymptoms.AddictBehav,30:589–594.Davidson,L.,&Rowe,M.(2008).Peersupportwithincriminaljusticesettings:Theroleofforensicpeerspecialists.Belmar,NY:CMHSNationalGAINSCenter.deAndrade,D.,Kinner,S.A.,(2017).Systematicreviewofhealthandbehaviouraloutcomesofsmokingcessationinterventionsinprisons.TobaccoControl,26:495-501.DepartmentofHealthandHMPrisonService.(2003).Acquitted–Bestpracticeguidancefordevelopingsmokingcessationservicesinprison.London.DePue,J.D.,Goldstein,M.G.,Schilling,A.,Reiss,P.,Papandonatos,G.,Sciamanna,C.,&Kazura,A.(2012).DisseminationoftheAHCPRclinicalpracticeguidelineincommunityhealthcentres.JournalofTobaccoControl,11(4),329-335.Donahue,J.J.(2009).Tobaccosmokingamongincarceratedindividuals:Areviewofthenatureoftheproblemandwhat�isbeingdoneinresponse.JournalofOffenderRehabilitation,48,589-604.Ferguson,S.G.,Shiffman,S.,&Gitchell,J.G.(2011).Nicotinereplacementtherapies:Patientsafetyandpersistence.PatientRelatedOutcomeMeasures,2,111–117.Fiore,M.C.,&Baker,T.B.(2011).Treatingsmokersinthehealthcaresetting.NewEnglandJournalofMedicine,365,1222-1231.Fiore,M.C.,Jaen,C.R.,Baker,T.B.,etal.(2008).Treatingtobaccouseanddependence:2008updateU.S.PublicHealthServiceClinicalPracticeGuidelineexecutivesummary.RespiratoryCare,53(9),1217-1222.FloridaStateUniversity.(2017).Tobaccoandyourbusiness.TheFloridaDepartmentofHealth.Foley,K.L.,Proescholdbell,S.,Herndon,Malek,S.,&Johnson,J.(2010).ImplementationandenforcementoftobaccobansintwoprisonsinNorthCarolina:aqualitativeinquiry.JCorrectHealthCare,16:98.Freudenberg,N.(2001).Jails,prisons,andthehealthofurbanpopulations:Areviewoftheimpactofthecorrectionalsystemoncommunityhealth.JournalofUrbanHealth,78(2),214-235.

24

Garver-Apgar,C.,Young,S.,Howard,B.,Udochi,B.,Morris,C.(2017).EffectsofastatewidetobaccocessationprogramamongindividualsinvolvedwithArkansasCommunityCorrection.JournalofCorrectionalHealthCare,23(3),259-270.Glaser,J.B.,&Greifinger,R.B.(1993).Correctionalhealthcare:Apublichealthopportunity.AnnalsofInternalMedicine,118(2),139-145.Glaze,L.E.,&Kaeble,D.(2014).CorrectionalPopulationsintheUnitedStates,2013.BulletinNCJ248479.Washington,D.C.:UnitedStatesDepartmentofJustice,OfficeofJusticePrograms,BureauofJusticeStatistics.Grant,B.F.,Hasin,D.S.,Chou,S.P.,Stinson,F.S.,&Dawson,D.A.(2004).NicotinedependenceandpsychiatricdisordersintheUnitedStates:resultsfromthenationalepidemiologicsurveyonalcoholandrelatedconditions.ArchivesofGeneralPsychiatry,61(11),1107-1115.Greenbacker,L.,Keith,J.,Ochs,J.,&Becker,L.(2017,March21).ProvidingTobaccoCessationSupportinaStateCorrectionalFacility.PresentedattheNAQCConferenceAustin,TexasHam,D.C.,Przybeck,T.,Strickland,J.R.,Luke,D.A.,Beirut,L.J.,&Evano,B.A.(2011).Occupationandworkplacepoliciespredictsmokingbehaviors:Analysisofnationaldatafromthecurrentpopulationsurvey.JournalofOccupationalandEnvironmentalMedicine,53(11),1337-45.Hammett,T.M.,Roberts,C.,&Kennedy,S.(2001).Healthrelatedissuesinprisonerreentry.Crime&Delinquency,47(3),390-409.Hettema,J.E.,&Hendricks,P.S.(2010).Motivationalinterviewingforsmokingcessation:ameta-analyticreview.JournalofConsultingandClinicalPsychology,78(6),868-884.Jalali,F.,Afshari,R.,Babei,A.,Abasspour,H.&Vahedian-Shahroodi,M.(2015).ComparingMotivationalInterviewing-BasedTreatmentanditscombinationwithNicotineReplacementTherapyonsmokingcessationinprisoners:arandomizedcontrolledclinicaltrial.ElectronPhysician,7(6):1318-1324.James&Glaze.(2006).MentalHealthProblemsofPrisonandJailInmates.BureauofJusticeStatistics,U.S.DepartmentofJustice.Retrievedfrom:https://www.bjs.gov/content/pub/pdf/mhppji.pdf.Kauffmanetal.(2011).TobaccoUsebyMalePrisonersUnderandIndoorSmokingBan.Nicotine&TobaccoResearch,13(6):449-456.Kauffmanetal.(2008).TobaccoPolicyinAmericanPrisons.TobaccoControl,17,357-359.Kennedy,S.M.,Davis,S.P.,&Thorne,S.L.(2015).Smoke-freepoliciesinU.S.PrisonsandJails:AReviewoftheLiterature.Nicotine&TobaccoResearch,17(6):629-635.Kim,J.Y.,Rich,J.,Zierler,S.,Lourie,K.,Vigilante,K.,Normandie,L.,...&Flanigan,T.P.(1997).Successfulcommunityfollow-upandreducedrecidivisminHIVpositivewomenprisoners.JournalofCorrectionalHealthCare,4(1),5-17.

25

Lai,D.T.,Cahill,K.,Qin,Y.,&Tang,J.L.(2010).Motivationalinterviewingforsmokingcessation.CochraneDatabaseofSystematicReviews,1,CD006936.LasnierB,CantinottiM,GuyonL,RoyerA,BrochuS,ChayerL.(2011).Implementinganindoorsmokingbaninprison:enforcementissuesandeffectsontobaccouse,exposuretosecond-handsmokeandhealthofinmates.CanJPublicHealth,102:249.Lasser,K.,Boyd,J.W.,Woolhandler,S.,Himmelstein,D.U.,McCormick,D.,&Bor,D.H.(2000).Smokingandmentalillness:Apopulation-basedprevalencestudy.JournaloftheAmericanMedicalAssociation,284(20),2606-2610.Lincoln,T.,Tuthill,R.W.,Roberts,C.A.,Kennedy,S.,Hammett,T.M.,Langmore-Avila,E.,&Conklin,T.J.(2009).Resumptionofsmokingafterreleasefromatobacco-freecorrectionalfacility.JournalofCorrectionalHealthCare,15(3),190-196.Lindson,N.,&Aveyard,P.(2011).Anupdatedmeta-analysisofnicotinepreloadingforsmokingcessation:Investigatingmediatorsoftheeffect.Psychopharmacology,214,579-592.Longo,D.R.,Stone,T.T.,Phillips,R.L.,Everett,K.D.,Kruse,R.L.,Jaen,C.R.,&Hewett,J.E.(2006).Characteristicsofsmokingcessationguidelineusebyprimarycarephysicians.MissouriMedicine,103(2),180-184.Lundahl,B.,Kunz,C.,Brownell,C.,Tollefson,D.,&Burke,B.(2010).Ameta-analysisofmotivationalinterviewing:Twenty-fiveyearsofempiricalstudies.ReseachonSocialWorkPractice,20(2),137-160Lurigio,A.J.(2011).Co-occurringdisorders:Mentalhealthanddrugmisuse.In:Leukefeld,C.,Gullotta,T.,Gregrich,J.(eds)HandbookofEvidence-BasedSubstanceAbuseTreatmentinCriminalJusticeSettings.IssuesinChildren'sandFamilies'Lives,vol11.Springer,NewYork,NYMacAskill,S.&Hayton,P.(2007).StopSmokingSupport�inHMPrisons:TheImpactofNicotineReplacementTherapy.ExecutiveSummaryandBestPracticeChecklist.Stirling,Scotland:UniversityofStirling,TheOpenUniversity,&CentreforTobaccoControlResearch.MacDonald,L.,Angus,K.,MacAskill,S.,&Eadie,D.(2010).Rapidliteraturereviewofsmokingcessationandtobaccocontrolissuesacrosscriminaljusticesystemsettings.Stirling,Scotland:UniversityofStirling&TheOpenUniversity.Retrievedfrom:https://www.uclan.ac.uk/research/explore/projects/assets/tobacco_control_cjs_lit_review_aug_2010.pdfMaricopaCountyAdultProbation.(2015).AnnualReport:MaricopaCountyAdultProbation.Retrievedfrom:https://www.superiorcourt.maricopa.gov/AdultProbation/docs/2015AnnualReport.pdfMaurer,K.(2014).TobaccoUseinanIncarceratedPopulation:AnIssueofHealthEquity.PresentedattheAcademicandHealthPolicyConferenceonCorrectionalHealth.Houston,Texas.Meshefedjian,G.A.,Gervais,A.,Tremblay,M.,Villeneuve,D.,&O’Loughlin,J.(2010).Physiciansmokingstatusmayinfluencecessationcounselingpractices.CanadianJournalofPublicHealth,101,290–293.

26

Miller,W.R.,&Rollnick,S.(2013).MotivationalInterviewing:HelpingPeopleChange.3rded.NewYork,NY:TheGuilfordPress.Moore,D.,Aveyard,P.,Connock,M.,Wang,D.,Fry-Smith,A.,&Barton,P.(2009).Effectivenessandsafetyofnicotinereplacementtherapyassistedreductiontostopsmoking:Systematicreviewandmeta-analysis.BMJ,338,b1024.Morris,C.,Miller,B.,&Mahalik,J.(2011).Anexpandedopportunitytoprovidetobaccocessationservicesinprimarycare.TranslationalBehavioralMedicine,1(1),31-34.Morris,C.D.,Waxmonsky,J.A.,May,M.G.,&Giese,A.A.(2009).Whatdopersonswithmentalillnessesneedtoquitsmoking?Mentalhealthconsumerandproviderperspectives.PsychiatricRehabilitationJournal,32(4),276-284.Muir,S.&Marshall,B.(2016).ChangesinHealthPerceptionsofMalePrisonersFollowingaSmokingCessationProgram.JournalofCorrectionalHealthCare,22(3):247-56.Noonan,M.E.(2012).Mortalityinlocaljailsandstateprison,2000-2010–statisticaltables.Mortality.Retrievedfromhttp://www.bjs.gov/content/pub/pdf/mljsp0010st.pdfNorthAmericanQuitlineConsortium.(2015).Resultsfromthe2015NAQCAnnualSurveyofQuitlines.Retrievedfromhttp://www.naquitline.org/?page=2015SurveyOkuyemi,K.S.,Goldade,K.,Whembolua,G.L.,Thomas,J.L.,Eischen,S.,Sewali,B.,...Ahluwalia,J.S.(2013).Motivationalinterviewingtoenhancenicotinepatchtreatmentforsmokingcessationamonghomelesssmokers:arandomizedcontrolledtrial.Addiction,108(6):136-44.Park,E.R.,Gareen,I.F.,Japuntich,S.,Lennes,I.,Hyland,K.,DeMello,S.,Sicks,J.D.,&Rigotti,N.A.(2015).Primarycareprovider-deliveredsmokingcessationinterventionsandsmokingcessationamongparticipantsintheNationalLungScreeningTrial.JAMAInternalMedicine,175(9),1509-151.Peters,R.H.,Kremling,J.,Bekman,N.M.,&Caudy,M.S.(2012).Co-occurringdisordersintreatment-basedcourts:Resultsofanationalsurvey.BehavioralSciences&theLaw,30(6),800-820.Proescholdbell,S.K.,Foley,K.L.;Johnson,J.,Herndon,M.S.(2008).Indoorairqualityinprisonsbeforeandafterimplementationofasmokingbanlaw.TobaccoControl,17,123–127.Puljević,C.,deAndrade,D.,Carroll,M.,etal.(2017).Useofprescribedsmokingcessationpharmacotherapyfollowingreleasefromprison:aprospectivedatalinkagestudy.TobaccoControl,PublishedOnlineFirst:28August2017.Richmond,R.L.,Butler,T.,Belcher,J.M.,Wodak,A.,Wilhelm,K.A.,&Baxter,E.(2006).Promotingsmokingcessationamongprisoners:feasibilityofamulti-componentintervention.AustNZJPublicHealth,30(5):474–8.Rose,J.E.,Herskovic,J.E.,Behm,F.M.,&Westman,E.C.(2009).Precessationtreatmentwithnicotinepatchsignificantlyincreasesabstinenceratesrelativetoconventionaltreatment.Nicotine&TobaccoResearch,11(9),1067-1075.

27

Rowe,M.,Bellamy,C.,Baranoski,M.,Wieland,M.,O’Connell,M.,Benedict,P.,etal.(2007).APeerSupport,GroupInterventiontoReduceSubstanceUseandCriminalityAmongPersonsWithSevereMentalIllness.PsychiatricServices,58,955-961.SabolW.J.,&MintonT.D.(2007).BureauofJusticeStatisticsBulletin:jailinmatesatmidyearWashington,DC:U.S.DepartmentofJustice.Sacks,S.,Sacks,J.,McKendrick,K.,Banks,S.,&Stommel,J.(2004).ModifiedtherapeuticcommunityforMICAoffenders.Crimeoutcomes.BehavioralSciences&theLaw,22(4),477-501.Shiffman,S.&Ferguson,S.G.(2008).Nicotinepatchtherapypriortoquittingsmoking:Ameta-analysis.Addiction,103(4),557-563.Stead,L.F.,Perera,R.,&Lancaster,T.(2007).Asystematicreviewofinterventionsforsmokerswhocontactquitlines.TobaccoControl,16(1):i3-i8.Steadman,H.,Osher,F.,Robbins,P.C.,Case,B.,&Samuels,S.(2009).Prevalenceofseriousmentalillnessamongjailinmates.PsychiatricServices,60(6),761-765.Steadman,H.J.,Peters,R.H.,Carpenter,C.,Mueser,K.T.,Jaeger,N.D.,Gordon,R.B.,…Hardin,C.(2013).Sixstepstoimproveyourdrugcourtoutcomesforadultswithco-occurringdisorders.NationalDrugCourtInstituteandSAMHSA’sGAINSCenterforBehavioralHealthandJusticeTransformation.DrugCourtPractitionerFactSheet,8(1),1-28.AlexandriaVA:NationalDrugCourtInstitute.SubstanceAbuseandMentalHealthServicesAdministration[SAMHSA].(2013).Adultswithmentalillnessorsubstanceusedisorderaccountfor40percentofallcigarettessmoked.TheNSDUHReport.Retrievedfromhttp://www.samhsa.gov/data/sites/default/files/spot104-cigarettes-mental-illness-substance-use-disorder/spot104-cigarettes-mental-illness-substance-use-disorder.pdfSubstanceAbuseandMentalHealthServicesAdministration(2012).InvolvingPeersinCriminalJustice&Problem-SolvingCollaboratives.SAMHSA’sGAINSCenterforBehavioralHealthandJusticeTransformation.Retrieved:https://www.yumpu.com/en/document/view/49994762/involving-peers-in-criminal-justice-amp-problem-solving-collaborativesThibodeau,L.,Jorenby,D.E.,Seal,D.W.,Kim,S.Y.,&Sosman,J.M.(2010).Prereleaseintentpredictssmokingbehaviorpostreleasefollowingaprisonsmokingban.Nicotine&TobaccoResearch,12(2),152-158.TobaccoControlLegalConsortium(2012).Tobaccoinadultcorrectionalfacilities:Apolicyoverviewfactsheet.Retrievedfromhttp://www.publichealthlawcenter.orgTorchalla,I.,Strehlau,V.,Okoli,C.T.C.,Li,K.,Schuetz,C.,&Krausz,M.(2011).Smokingandpredictorsofnicotinedependenceinahomelesspopulation.Nicotine&TobaccoResearch,13(12),1-9.Turan,O.&Turan,A.P.(2017).Smoking-RelatedBehaviorsandEffectivenessofSmokingCessationTherapyAmongPrisonersandPrisonStaff.RespiratoryCare,61(4):434-438.

28

USDepartmentofHealthandHumanServices.(2006).Thehealthconsequencesofinvoluntaryexposuretotobaccosmoke:Areportofthesurgeongeneral.Atlanta,GA:USDepartmentofHealthandHumanServices,CentersforDiseaseControlandPrevention,OfficeonSmokingandHealth.U.S.DepartmentofHealthandHumanServices.(2014).Thehealthconsequencesofsmoking:50yearsofprogress:Areportofthesurgeongeneral.Atlanta,GA:U.S.DepartmentofHealthandHumanServices,CentersforDiseaseControlandPrevention,NationalCenterforChronicDiseasePreventionandHealthPromotion,OfficeonSmokingandHealth.U.S.DepartmentofHealthandHumanServices[USDHHS],CentersforDiseaseControl,andPrevention,NationalCenterforChronicDiseasePreventionandHealthPromotion,OfficeonSmokingandHealth.(2004).Thehealthconsequencesofsmoking.AreportoftheSurgeonGeneral.Retrievedfromhttp://www.cdc.gov/tobacco/data_statistics/sgr/2004/complete_report/index.htmU.S.DepartmentofHealthandHumanServices[USDHHS],TobaccoUse&ControlPanel.(2008).TreatingTobaccoUse&Dependence:2008Update.Retrievedfromhttp://www.ncbi.nlm.nih.gov/books/NBK63952/vandenBerg,J.J.,Bock,B.C.,Roberts,M.B.,Parker,D.R.,Martin,R.A.,Stein,L.A.,Clarke,J.G.(2016).GoalsandPlansofIncarceratedMenPostrelease.JournalofCorrectionalHealthCare,22(2):146-56.Wilper,A.P.,Woolhandler,S.,Boyd,J.W.,Lasser,K.E.,McCormick,D.,Bor,D.H.,&Himmelstein,D.U.(2009).ThehealthandhealthcareofUSprisoners:Resultsofanationwidesurvey.AmericanJournalofPublicHealth,99(4),666-672.WolfHarlow,C.(2003).EducationandCorrectionalPopulations.Bulletin.NCJ195670.Washington,D.C.:UnitedStatesDepartmentofJustice,OfficeofJusticePrograms,BureauofJusticeStatistics.Zhu,S.H.,Anderson,C.M.,Johnson,C.E.,Tedeschi,G.,&Roeseler,A.(2009).Acentralisedtelephoneservicefortobaccocessation:theCaliforniaexperience.TobacooControl,9(2),ii48-55.