Use of prescribed smoking cessation pharmacotherapy following release from prison: a prospective data linkage study.

Abstract:

BACKGROUND:A significant proportion of people who cycle through prisons express a desire to quit smoking, yet smoking rates in this population are two to four times higher than in the general community. Smoking cessation pharmacotherapy (SCP) is an important component of evidence-based cessation support, yet no studies have examined use of this pharmacotherapy after release from prison. METHODS:We linked data from a survey of 971 smokers who were within 8 weeks of release from prison in Queensland, Australia, with federal Pharmaceutical Benefits Scheme (PBS) records for the 2 years after release, to identify subsidised use of SCP (varenicline, bupropion and nicotine patches). We used Cox proportional hazards regression to identify independent predictors of SCP use. FINDINGS:According to PBS data, 86 participants (8.9%) accessed SCP in the 2 years following release from prison. Participants who were aged 25 years or older (HR 2.51, 95% CI 1.19 to 5.31), employed before prison (HR 1.93, 95% CI 1.14 to 3.28), highly nicotine dependent at baseline (HR 2.21, 95% CI 1.23 to 3.97) and using non-psychotropic medications in prison (HR 2.29, 95% CI 1.24 to 4.22) were more likely to use subsidised SCP during follow-up. CONCLUSION:Despite a very high rate of tobacco use among people cycling through prisons and the very low cost of (subsidised) SCP in Australia, few ex-prisoners obtain pharmaceutical assistance with quitting smoking. Policy attention needs to focus on supporting former prisoners to access SCP, to reduce the high rate of tobacco-related morbidity and mortality in this profoundly marginalised population.

journal_name

Tob Control

journal_title

Tobacco control

authors

Puljević C,de Andrade D,Carroll M,Spittal MJ,Kinner SA

doi

10.1136/tobaccocontrol-2017-053743

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

474-478

issue

4

eissn

0964-4563

issn

1468-3318

pii

tobaccocontrol-2017-053743

journal_volume

27

pub_type

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