Tobacco use and secondhand smoke kill over 480,000 people in the United States annually. The mortality rate of smokers is three times higher than those who have never smoked, according to the Centers for Disease Control and Prevention, and smoking reduces an average smoker’s life expectancy by 10 years compared to non-smokers. While the exact numbers aren’t known, numerous prisoners die every year due to smoking-related ailments such as cancer, stroke, heart disease and chronic lung disease.

Many state prison systems imposed tobacco bans following a 1993 Supreme Court decision that found exposure to secondhand smoke could constitute cruel and unusual punishment in violation of the Eighth Amendment. [See: PLN, Sept. 1993, p.1]. In 2001, 25 states had introduced full or partial smoking bans in their correctional facilities; that number rose to 48 states by 2011.

Federal prison commissaries stopped selling tobacco in 2006, and the federal Bureau of Prisons moved to ban smoking, except for certain religious ceremonies, in 2014. “It creates a healthier environment for staff and inmates,” said BOP spokesman Ed Ross.

Other countries have already imposed or are in the process of implementing tobacco bans in their prison systems, though not all prisoners are happy about such policies. In June 2015, hundreds of Australian prisoners rioted after thirteen facilities in the state of Victoria stopped selling tobacco products and prohibited smoking. [See: PLN, Oct. 2015, p.63]. The prison system in the United Kingdom plans to impose a smoking ban this year. [See: PLN, Feb. 2016, p.63].

Critics have voiced concerns that such policies create a profitable black market for tobacco sales, which financially benefits gangs and already-established smuggling operations while posing additional safety concerns for both staff and prisoners. Employees are also more inclined to smuggle cigarettes than illegal drugs into prisons, which increases the risk of corruption among staff members.

There is a dearth of research on the results and potential impact of prison smoking bans. However, one U.S. study published in the British Medical Journal (BMJ) in August 2014, comparing mortality rates in prisons that ban tobacco with those that do not, found facilities with long-term bans reduced smoking-related deaths by up to 11 percent.

At the end of 2011, the state prison population totaled 1.4 million. Sixty to 80% of prisoners reported smoking – a rate substantially higher than in the general population. Further, limited access to fresh air due to confinement means non-smoking prisoners are more exposed to second-hand smoke than they would be outside of prison. In fact, smoking-attributable deaths are substantially higher in prison, at a rate of 360 per 100,000 population, than in the general U.S. population with a comparable rate of 248 per 100,000.

According to the BMJ research study, while prisons with smoking bans saw a 9% decrease in smoking-related deaths, those with bans in effect for over nine years reported an 11% reduction in smoking-related deaths, including a 19% reduction in cancer deaths and a 34% reduction in pulmonary deaths compared to prisons without bans.

These findings suggest that smoking bans have had significant health benefits for prisoners, even though many resume smoking following their release from custody. Researchers have called for additional study and improved efforts to “promote effective long-term [smoking] cessation in prisons and after release as a part of a comprehensive tobacco strategy” for prisoners, who were called a “high-risk group.”

Yet at least one prison system has relaxed its smoking ban. The Florida Department of Corrections (FDOC) banned tobacco products among prisoners – but not staff members – in September 2011, to “reduce the medical cost associated with exposure to tobacco, and eliminate secondhand smoke exposure to non-smokers.” Four years later prison officials partially reversed the ban, allowing prisoners at work release centers to possess up to 10 packs of cigarettes, effective June 13, 2015.

The partial reversal was based on the FDOC’s inability to control the flow of contraband cigarettes. “The Department determined, after assessment, that it was a better use of resources to not find an inmate in violation, which would potentially cause him/her to go back into prison, for possession of tobacco when so far along in the process of transitioning back into the community, hopefully as a productive citizen,” said FDOC spokeswoman Jessica Cary.

According to prison administrators, in the first six months after the smoking ban went into effect, nearly 30,000 prisoners or staff members were caught with some sort of tobacco contraband. At up to $10 per cigarette, employees have an incentive to smuggle cigarettes in exchange for bribes. The FDOC had initially prohibited staff from bringing tobacco products into state prisons, but after employees protested the department relented. Although by policy staff members are supposed to smoke out of sight of prisoners, guards reportedly smoke openly.

In November 2015, a report by independent consulting firm CGL found that the FDOC’s “policy on tobacco use has created a secondary market for the trafficking of tobacco products and for staff to violate policies and become complicit in the supply of contraband.” The report recommended that Florida prisons “should become tobacco-free institutions” for both prisoners and employees.

Sources: “Prison tobacco control policies and deaths from smoking in United States prisons: Population based retrospective analysis,” British Medical Journal (Aug. 5, 2014); www.redorbit.com; www.sciencedaily.com; www.medicaldaily.com; www.themarshallproject.org; www.cdc.gov; Miami Herald; www.oppaga.state.fl.us

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