Characteristics of individuals that complete treatment v. discontinue among criminal justice smokers

Abstract

Background Tobacco kills over 7 million people annually worldwide and is the leading cause of preventable deaths in the United States. Individuals in criminal corrections are at increased risk for tobacco-related diseases and represent a particularly vulnerable group of tobacco smokers. Within the criminal justice system, there are elevated smoking rates (70-80%) and reduced availability of smoking cessation interventions. Further, these individuals experience significant individual- and social network-level barriers to completing interventions. The purpose of this study was to examine differences among individuals who completed treatment as compared to those who discontinued treatment prematurely among individuals within criminal corrections. Methods The present study utilized data from a one-year clinical trial which randomized participants to four-weeks of Bupropion medication and/or behavioral counseling treatment. Participants (N=500) were recruited from the criminal justice population (M age = 37.4, 67% male, 68% non-white). A battery of questionnaires assessed smoking characteristics and mental health history. A one-way analysis of variance (ANOVA) and chi-square analyses were conducted to determine differences among individuals who completed up to 1 month, 3 months, 6 months or 12 months of treatment. Results Individuals were more likely complete all 12 months of treatment if they were African American, demonstrated good medication compliance, never married, not receiving disability services, and never been treated for substance abuse. Strong smoking urges were associated with lower completion at 1 and 3 months, however, high nicotine dependence was associated with lower completion rates for all time points. A strong social support network was associated with higher rates of completing 12 months of treatment. Conclusions This study contributes to our understanding of a vulnerable group of smokers. While smoking urges are related to lower completion initially, nicotine dependence, social support and medication compliance lead to long-term success in treatment completion. Treatments would benefit from strengthen these factors to improve long-term outcomes.

Keywords

• WCTOH