Objective: To examine current tobacco policy in US prisons and explore changes in prison tobacco policies over time.
Data source: Telephone survey of the 52 US departments of correction.
Main outcome measures: Current tobacco policy; distribution of free tobacco; availability of smoking cessation programming and cessation aids.
Participants: Complete responses were received from 51 of 52 (98%) departments, while one provided partial information.
Results: The majority of correctional systems (60%) reported total tobacco bans on prison grounds, with most remaining facilities (27%) having an indoor ban on tobacco use. No prisons distributed free tobacco. No major violence was reported relating to the implementation of stricter tobacco policies; however many respondents noted that tobacco became a major contraband item following the implementation of a total ban. While most prison systems with an indoor tobacco ban (86%) reported having tobacco cessation programmes, few of those with total bans (39%) continued such programmes after the initial transition period.
Conclusion: Total tobacco bans have often been accompanied by the termination of tobacco cessation programmes. Such actions undermine efforts to promote long-term cessation resulting in a missed public health opportunity.