Dickert Jeff, Williams Jill M, Reeves Rusty, Gara Michael, DeBilio Lisa
Dr. Dickert, Dr. Reeves, and Dr. DeBilio are with University Correctional Health Care, Rutgers University, Trenton, New Jersey. Dr. Williams and Dr. Gara are with the Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, where Dr. Dickert and Dr. Reeves are also affiliated. Dr. Gara is also with University Behavioral Health Care, Rutgers University, Piscataway, New Jersey. Send correspondence to Dr. Williams (e-mail:
Psychiatr Serv. 2015 Sep;66(9):975-9. doi: 10.1176/appi.ps.201400429. Epub 2015 May 15.
Negative health consequences of smoking have prompted many correctional facilities to become tobacco free, including the New Jersey Department of Corrections, and this study examined the results of implementing tobacco-free policies.
Mortality rates in the total population of inmates and in a subgroup with identified special mental health needs or mental illnesses (referred to in this article as persons with special needs) were measured from January 2005 through June 2014, a period during which tobacco use was significantly reduced and then eliminated.
The total mortality rate of all causes of death combined was three times higher for persons with special needs in 2005 compared with those without special needs. The total annual mortality rate decreased by 13%, from 232 to 203 per 100,000 population between 2005 and 2013. The mortality rate for persons identified as having special needs decreased by 48%, from an average of 676 per 100,000 population over the eight-year period before the ban to 353 per 100,000 in the 18 months after the ban. Reduced mortality among persons with special needs between 2005 and 2014 in half-year increments was correlated with the reduction and elimination of tobacco products (median bootstrapped Pearson r=.60, 95% confidence interval [CI] =.21 to .86). In strong contrast, however, the bootstrapped correlation between the mortality rate of persons not identified as having special needs and tobacco sales over the same period was not significant (median Pearson r=-.13, CI=-.50 to .28). No other major medical intervention occurred during these years.
This striking correlation of quick and substantial reduction of mortality among individuals with a mental illness in association with the reduction and subsequent ban of smoking suggests that smoking may play a major role in the reduced life span of persons with mental illness.
吸烟对健康的负面影响促使许多惩教机构实现无烟化，包括新泽西州惩教部，本研究调查了实施无烟政策的结果。
对2005年1月至2014年6月期间囚犯总人群以及有特定心理健康需求或精神疾病的亚组人群（本文中称为有特殊需求者）的死亡率进行了测量，在此期间烟草使用显著减少并最终消除。
2005年，有特殊需求者的所有死因总死亡率是无特殊需求者的三倍。2005年至2013年期间，总年死亡率下降了13%，从每10万人232例降至203例。被确定有特殊需求者的死亡率下降了48%，从禁令实施前八年期间的每10万人平均676例降至禁令实施后18个月的每10万人353例。2005年至2014年期间，有特殊需求者半年增量的死亡率降低与烟草制品的减少和消除相关（中位数自抽样皮尔逊相关系数r = 0.60，95%置信区间[CI] = 0.21至0.86）。然而，形成强烈对比的是，同期未被确定有特殊需求者的死亡率与烟草销售量之间的自抽样相关性不显著（中位数皮尔逊相关系数r = -0.13，CI = -0.50至0.28）。这些年没有发生其他重大医疗干预。
精神疾病患者死亡率迅速大幅下降与吸烟减少及随后的禁烟之间的显著相关性表明，吸烟可能在精神疾病患者寿命缩短中起主要作用。
