Motivational factors related to quitting smoking among prisoners during a smoking ban.

Motivational factors and initial stages of change (precontemplation vs. contemplation) were investigated among incarcerated male smokers forced to quit smoking due to a statewide smoking ban. All smokers completed a baseline questionnaire, which assessed smoking history, nicotine dependence [Fagerstrom Test for Nicotine Dependence (FTND)], nicotine withdrawal [Hughes-Hatsukami Withdrawal Scale (HHWS)], and depression [Center for Epidemiological Studies on Depression (CES-D)]. These measures were given again 4 days (Time 2) and 1 month (Time 3) following the smoking ban. At baseline (n=314), 31.2% of smokers were contemplating quitting within 6 months (contemplators), while the majority of smokers (68.8%) indicated they had not considered quitting (precontemplators). Contemplators at Time 2 reported more success with quitting smoking than precontemplators, although this was no longer significant by Time 3. Logistic regression was used to determine the probability of determining initial stages of change based on demographic and smoking history variables. Smokers in precontemplation scored higher on the FTND, reported less agreement with the smoking policy at baseline, reported more difficulty with their previous quit attempts, and reported increased smoking in anticipation of the smoking ban. The risk of being a precontemplator was over twice as high for smokers who reported increasing the amount they smoked prior to the smoking ban (odds ratio=2.42). Overall, this model correctly classified 70.7% of the smokers. This suggests that initial stages of change plays an important role in eventual quitting even in environments in which smoking has been recently prohibited.