Predictors of medication adherence and smoking cessation among smokers under community corrections supervision.
Individuals in the U.S. criminal justice system now represent over 12% of all current U.S. smokers. With smoking banned in most U.S. jails and prisons, the cessation focus for this population has shifted to individuals who are under community correction supervision (e.g., probation, parole). The aim of this study was to examine predictors of successful smoking cessation among criminal justice individuals supervised in the community.



Five hundred participants under community corrections supervision were randomized to receive either four sessions of smoking cessation counseling or no counseling in conjunction with 12weeks of bupropion treatment plus brief physician advice to quit. Logistic regression analyses examined associations of smoking variables with medication adherence and successful abstinence. Mediation analysis evaluated the indirect effects of medication adherence on smoking abstinence.



The strongest associate of medication adherence was previous use of bupropion, while the strongest associate of smoking abstinence was medication adherence. Mediation analysis indicated that previous use of bupropion indirectly increased cessation rates through the pathway of increased medication adherence.



These results highlight the importance of medication adherence for smoking cessation among community corrections smokers. Providing exposure to medication may be a promising intervention to increase medication adherence and subsequent cessation rates in this population.
University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1016, 1720 2nd Ave. South, Birmingham, AL 35294, USA. Electronic address: kcropsey@uabmc.edu.
Karen L
KL
Cropsey
Wichita State University, Department of Psychology, Box 34, Wichita, Kansas 67260-0034, USA. Electronic address: C.brendan.clark@wichita.edu.
C Brendan
CB
Clark
Auburn Psychology Group, LLC. 861-D North Dean Road, Auburn, AL 36830, USA. Electronic address: Erinsteven@gmail.com.
Erin N
EN
Stevens
University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1016, 1720 2nd Ave. South, Birmingham, AL 35294, USA. Electronic address: schiavon@uab.edu.
Samantha
S
Schiavon
University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1016, 1720 2nd Ave. South, Birmingham, AL 35294, USA. Electronic address: alahti@uabmc.edu.
Adrienne C
AC
Lahti
University of Alabama at Birmingham, School of Public Health, Department of Health Behavior, 227L Ryals Public Health Building, 1665 University Blvd., Birmingham, AL 35294, USA. Electronic address: phendricks@uab.edu.
Peter S
PS
Hendricks
D000328:Adult; D016642:Bupropion / Q000627:therapeutic use*; D003376:Counseling / Q000379:methods*; D065690:Cytochrome P-450 CYP2D6 Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D011329:Prisoners / Q000706:statistics & numerical data*; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000188:drug therapy / Q000628:therapy*; D016903:Drug Monitoring
D065690:Cytochrome P-450 CYP2D6 Inhibitors; D016642:Bupropion
Criminal justice; Medication adherence; Smoking cessation