Sustaining Tobacco Abstinence after Incarceration

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With approximately 9 million Americans passing through correctional institutions annually and an average daily population of over 2 million, there are multiple opportunities to address the smoking cessation needs of this high risk and underserved population.1 Tobacco use among prisoners is approximately three times that of the general population2 and minorities, poor, mentally ill and illicit substance using individuals are all overrepresented in correctional facilities. Since the announcement of the negative health consequences of second hand smoke, correctional facilities are increasingly becoming tobacco free. The Rhode Island Department of Corrections (RI DOC) has been tobacco free since February 2003 with no tobacco products allowed anywhere on grounds by inmates or staff. However the majority of inmates return to smoking as soon as they are released back into the community. Motivational Interviewing (MI) can be conceptualized and informed by the self-determination theory. 3. 4 MI utilizes specific techniques for providing feedback based on an individual's risk, and self efficacy. CBT provides the skills necessary to maintain abstinence after release. We aim to capitalize on these periods of forced abstinence by modifying and evaluating an Intensive Behavioral Intervention (6 sessions of in jail MIICBT and two post release telephone booster sessions) compared to a CONcise Iapes Reviewing Obstacles to healthy biving (CONTROL) in a randomized clinical trial. We propose to randomly assign to Intensive ~ehavioral Intervention (lBI) or time equivalent CONTROL eight weeks before release from incarceration. Those randomized to IBI will receive two MI and four CBT sessions in prison and two booster telephone sessions after release. For this two year proposal we will limit follow-up to 12-weeks after release and censor follow-up for those who have relapsed to smoking.