title: Exploration of Incarcerated Men's and Women's Attitudes of Smoking in the Presence of Children and Pregnant Women: Is There a Disparity Between Smoking Attitudes and Smoking Behavior?
abstract: BACKGROUND
  A major health challenge facing persons who are incarcerated is tobacco smoking. Upon reentry to the community, concerns regarding smoking cessation may be less likely to receive needed attention. Many individuals have partners who are pregnant and/or reside in households where children and pregnant women live. We explored incarcerated adults' attitudes of smoking in the presence of children and pregnant women and how post-release smoking behaviors are influenced by their attitudes.
  
  
  METHODS
  Two hundred forty-seven incarcerated adults participated in a smoking cessation randomized clinical trial in a tobacco-free prison. An instrument was developed to examine smoking attitudes and behaviors around children and pregnant women. Moderating effects of smoking factors on post-release abstinence were examined by evaluating interactions between smoking factors and treatment group.
  
  
  RESULTS
  Four factors were defined using factor analysis: smoking around children; impact of smoking on child's health; awareness of environmental tobacco smoke (ETS) risk for pregnant women; and importance of smoking avoidance during pregnancy. We found moderation effects of smoking factors on smoking outcomes which included: treatment group by smoking behavior around children (β = 0.8085; standard error [SE] = 0.4002; P = .04); treatment group by impact of smoking on child's health (β = 1.2390; SE = 0.5632; P = .03) and for those smoking 50% fewer cigarettes post-release, treatment group by smoking impact on child's health (β = 1.2356; SE = 0.4436; P < .01).
  
  
  CONCLUSIONS
  Concern for smoking around children and pregnant women and awareness of ETS risk for pregnant women was not found to be significantly associated with smoking outcomes and requires additional investigation. Among individuals who continue to smoke post-release, effective ETS interventions are needed aimed at protecting children and pregnant women with whom they live.
authors.affiliation: Departments of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Providence, RI; Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI; Donna_Parker@Brown.edu.
authors.forename: Donna R
authors.initials: DR
authors.lastname: Parker
authors.affiliation: Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI;
authors.forename: Mary B
authors.initials: MB
authors.lastname: Roberts
authors.affiliation: Division of Infectious Diseases, Miriam Hospital, Providence, RI; Department of Medicine, Alpert Medical School of Brown University, Providence, RI;
authors.forename: Jacob J
authors.initials: JJ
authors.lastname: van den Berg
authors.affiliation: Center for Behavioral and Preventive Medicine, Department of Psychiatry, Brown University, Providence, RI;
authors.forename: Beth
authors.initials: B
authors.lastname: Bock
authors.affiliation: Department of Psychology, University of Rhode Island, Kingston, RI;
authors.forename: Lyn A R
authors.initials: LA
authors.lastname: Stein
authors.affiliation: Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI;
authors.forename: Rosemarie A
authors.initials: RA
authors.lastname: Martin
authors.affiliation: Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI; Department of OB/GYN, Alpert Medical School of Brown University, Providence, RI.
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Clarke
mesh_terms: D000328:Adult; D002648:Child; D000067576:Child Health; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011247:Pregnancy; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data*; D011330:Prisons; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D014028:Tobacco Smoke Pollution; D016387:Women's Health
chemical_list: D014028:Tobacco Smoke Pollution