(69) Circumstances Around Cigarette Use After Enforced Smoking Abstinence in an American Prison

Introduction: Most adults return to smoking following enforced tobacco abstinence when incarcerated in U.S. prisons. Little is known about the specific relapse triggers on re-entry. This study examines situational, affective, and motivational antecedents of return to smoking immediately following release from a tobacco-free prison.

Methods: Assessments were administered pre-release and 1 and 7 days post-release to 190 incarcerated adults who were smokers prior to incarceration. Those reporting smoking within 7 days post-release were asked about circumstances surrounding their first cigarette.

Results: Two-thirds reported smoking in the 7 days following release (76% of those in the first day) with the first cigarette smoked 21 hours post-release on average. Smoking occurred more quickly for women than men and for those who planned to smoke after release (ps from 0.05-0.001). Forty-one percent of participants smoked while waiting for a ride or on the way home, 68% were given their first cigarette, 28% reported first smoking when reuniting with others, 42% first smoked with smokers, and 26% first smoked as celebration. The moods most reported before smoking were happy (60%) or excited (41.5%). Factors reported that could have prevented smoking were avoiding other smokers (27%), avoiding stress (16%), not drinking/using drugs (12%), and not having access to cigarettes (11%).

Conclusions: High rates of return to smoking occurred rapidly when around other smokers, using other substances, and in a positive mood. Interventions that focus specifically on these factors and can be immediately accessed upon release are required to help sustain people’s desired abstinence.