Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
University of Alaska Anchorage, Anchorage, Alaska.
Epidemiol Rev. 2018 Jun 1;40(1):82-95. doi: 10.1093/epirev/mxy005.
Smoking tobacco contributes to 11.5% of deaths worldwide and, in some countries, more hospitalizations than alcohol and drugs combined. Globally in 2015, 25% of men and 5% of women smoked. In the United States, a higher proportion of people in prison smoke than do community-dwelling individuals. To determine smoking prevalence in prisons worldwide, we systematically reviewed the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines; we also examined whether prisons banned smoking or treated smokers. We searched databases for articles published between 2012 and 2016 and located 85 relevant articles with data representing 73.5% of all incarcerated persons from 50 countries. In 35 of 36 nations (97%) with published prevalence data, smoking for the incarcerated exceeded community rates 1.04- to 62.6-fold. Taking a conservative estimate of a 2-fold increase, we estimated that, globally, 14.5 million male and 26,000 female smokers pass through prisons annually. Prison authorities' responses include permitting, prohibiting, or treating tobacco use. Bans may temporarily improve health and reduce in-prison health care costs but have negligible effect after prison release. Evidence-based interventions for smoking cessation effective outside prisons are effective inside; effects persist after release. Because smoking prevalence is heightened in prisons, offering evidence-based interventions to nearly 15 million smokers passing through yearly would improve global health.
吸烟导致全球 11.5%的人死亡，在某些国家，因吸烟导致的住院人数超过酒精和毒品的总和。2015 年，全球 25%的男性和 5%的女性吸烟。在美国，监狱中吸烟的人数比例高于社区居民。为了确定全球监狱中的吸烟率，我们使用系统评价和荟萃分析的首选报告项目（PRISMA）指南对文献进行了系统回顾；我们还检查了监狱是否禁止吸烟或治疗吸烟者。我们在数据库中搜索了 2012 年至 2016 年期间发表的文章，并找到了 85 篇相关文章，这些文章的数据代表了来自 50 个国家的 73.5%的被监禁者。在 36 个有发表流行率数据的国家中的 35 个（97%），被监禁者的吸烟率是社区居民的 1.04 到 62.6 倍。根据吸烟人数增加两倍的保守估计，我们估计全球每年有 1450 万男性和 2.6 万名女性吸烟者会通过监狱。监狱管理部门的应对措施包括允许、禁止或治疗烟草使用。禁令可能会暂时改善健康状况并降低监狱内的医疗保健费用，但在释放后几乎没有影响。在监狱外有效的戒烟循证干预措施在监狱内也有效；释放后效果仍然持续。由于监狱中的吸烟率较高，为每年通过的近 1500 万吸烟者提供循证干预措施将改善全球健康状况。
