title: Cigarette smoking as an expression of independence and freedom among inmates in a tobacco-free prison in the United States.
abstract: BACKGROUND
  Most adults report initiation of cigarette smoking during adolescence, a time also marked by developmental striving for independence and freedom. Tobacco use may retain its association with independence and/or freedom into adulthood. This association may contribute to continued tobacco use and/or increased risk of relapse to smoking among some individuals. This study examines the relationship between cigarette smoking and perceptions of independence and freedom among inmates in a tobacco-free prison in the northeastern United States.
  
  
  METHODS
  Questionnaires administered to 247 male and female inmates 6 weeks prior to scheduled prison release assessed demographics, smoking history, nicotine dependence, attitudes toward smoking, and plans for tobacco use or abstinence after prison release. Perceptions of smoking as an expression of independence and freedom were measured using 2 items. Smoking was assessed 3 weeks postrelease.
  
  
  RESULTS
  Constructs of freedom and independence were correlated but did not overlap completely. Both constructs were negatively associated with plans for smoking abstinence after prison release, and with perceived costs of continued smoking. Number of cigarettes smoked postrelease and perception of the pros of smoking were associated with freedom, but not independence.
  
  
  CONCLUSIONS
  Associations of smoking as an expression of freedom and independence may negatively influence plans for renewed smoking after a forced abstinence. Additional research is needed to determine the degree to which these 2 constructs predict smoking behavior and whether they can be used to improve interventions for incarcerated smokers.
authors.affiliation: Warren Alpert Medical School of Brown University, Providence, RI;
authors.forename: Jacob J
authors.initials: JJ
authors.lastname: van den Berg
authors.forename: Beth
authors.initials: B
authors.lastname: Bock
authors.forename: Mary B
authors.initials: MB
authors.lastname: Roberts
authors.forename: Lynda A R
authors.initials: LA
authors.lastname: Stein
authors.forename: Peter D
authors.initials: PD
authors.lastname: Friedmann
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Martin
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Clarke
mesh_terms: D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009511:New England / Q000453:epidemiology; D026684:Personal Autonomy; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D011330:Prisons; D016032:Randomized Controlled Trials as Topic; D061845:Smoke-Free Policy; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D055815:Young Adult