Sustaining Tobacco Abstinence after Incarceration

由于每年约有900万美国人通过惩教机构，平均每天有200多万人口，因此有多种机会满足这一高风险和服务不足人群的戒烟需求。1囚犯的烟草使用量大约是普通人群的三倍2，少数族裔、穷人、精神病患者和使用非法药物的个人在惩教机构中的比例都过高。 自从宣布二手烟对健康的负面影响以来，惩教设施越来越多地成为无烟场所。罗德岛州惩教署(RI DOC)自2003年2月以来一直是无烟的，囚犯或工作人员不得在任何地方使用烟草产品。然而，大多数囚犯一被释放回到社区，就会重新开始吸烟。 动机访谈可以通过自我决定理论进行概念化和知识化。3.4 MI使用特定的技术来提供基于个体风险和自我效能的反馈。CBT提供了在释放后保持禁欲所需的技能。我们的目标是利用这些时期的 在随机临床试验中，通过修改和评估密集的行为干预(6次监狱中的MIICBT会议和两次释放后电话强化会议)来强制禁欲，而不是回顾健康生活障碍的简明磁带(对照)。我们建议随机分配给 在出狱前8周进行强化行为干预(LBI)或时间等值控制。那些被随机分配到IBI的人在获释后将在监狱中接受两次MI和四次CBT治疗，并接受两次强化电话治疗。对于这项为期两年的提案，我们将把随访限制在释放后12周内，并审查那些重新吸烟的人的随访。

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.