title: Smoke-free policies in U.S. Prisons and jails: A review of the literature.
abstract: BACKGROUND
  Despite progress in limiting exposure to secondhand smoke (SHS) in the United States, little is known about the impact of smoke-free polices in prisons and jails. SHS exposure in this setting may be great, as smoking prevalence among inmates is more than three times higher than among non-incarcerated adults. To inform the implementation of smoke-free policies, this article reviews the literature on the extent, nature, and impact of smoke-free policies in U.S. prisons and jails.
  
  
  METHODS
  We systematically searched PubMed, Embase, EconLit, and Social Services Abstracts databases. We examined studies published prior to January 2014 that described policies prohibiting smoking tobacco in adult U.S. correctional facilities.
  
  
  RESULTS
  Twenty-seven studies met inclusion criteria. Smoke-free policies in prisons were rare in the 1980s but, by 2007, 87% prohibited smoking indoors. Policies reduced SHS exposure and a small body of evidence suggests they are associated with health benefits. We did not identify any studies documenting economic outcomes. Non-compliance with policies was documented in a small number of prisons and jails, with 20%-76% of inmates reporting smoking in violation of a policy. Despite barriers, policies were implemented successfully when access to contraband tobacco was limited and penalties were enforced.
  
  
  CONCLUSIONS
  Smoke-free policies have become increasingly common in prisons and jails, but evidence suggests they are not consistently implemented. Future studies should examine the health and economic outcomes of smoke-free policies in prisons and jails. By implementing smoke-free policies, prisons and jails have an opportunity to improve the health of staff and inmates.
authors.affiliation: Biostatistics and Epidemiology, RTI International, Atlanta, GA; vnd2@cdc.gov.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Kennedy
authors.affiliation: Epidemiology Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Shane P
authors.initials: SP
authors.lastname: Davis
authors.affiliation: Epidemiology Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Thorne
mesh_terms: D006801:Humans; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons / Q000706:statistics & numerical data / Q000639:trends*; D061845:Smoke-Free Policy / Q000639:trends*; D012907:Smoking / Q000453:epidemiology*; D014028:Tobacco Smoke Pollution; D014481:United States / Q000453:epidemiology
chemical_list: D014028:Tobacco Smoke Pollution