Providing Tobacco Cessation Support in a State Correctional Facility

Background: Since 2002, the Pennsylvania (PA) Department of Health, Division of Tobacco Prevention and Control (DTPC), has provided telephone-based cessation counseling through the PA Free Quitline. The PA Free Quitline provides free counseling and support to tobacco users in the state as young as 14 and, when possible, nicotine replacement therapy (NRT) to adults. The Tobacco Control Legal Consortium estimates that 70-80% of incarcerated persons use tobacco. In 2015, DTPC, National Jewish Health (NJH) (PA Free Quitline vendor), and the PA Department of Corrections partnered to enact a pilot program extending cessation services to women at SCI Muncy, a maximum security prison, as their incarceration status does not allow them to access PA Free Quitline by telephone.

This presentation will describe the steps taken to implement the program at Muncy, recruitment, adjustments made to Quitline protocol based on needs of an institutionalized population, and strategies used to overcome challenges. Findings from qualitative data collected from key staff and Muncy inmates will be presented.

Methods: Evaluation of the corrections pilot included document review, intake data analysis, interviews with NJH counselors and key personnel at PA DTPC, and focus groups with inmates who participated in the pilot program. As the sample of participating inmates is small, initial evaluation focused on process and intake/utilization data rather than quit rates.

Results: Fourteen participants received counseling in 2015, with 13 completing five counseling sessions. Quitline protocol was adjusted to comply with corrections facility regulations and intake questions were revised to ensure sensitivity to incarcerated persons. Rather than telephone-based counseling, pilot participants received counseling services through TeleMed video-conferencing. Sessions were pre-scheduled, and participants could only speak to counselors at those times, whereas non-incarcerated individuals are free to call at any time. Pilot participants were offered eight weeks’ worth of NRT patches which were sent to Muncy medical staff for controlled distribution. Participants’ reactions to the program were overwhelmingly positive, with many requesting that the program be implemented more widely so that they could encourage others to participate or re-enroll.

Next Steps: Lessons learned include the timing of counseling sessions, technology glitches, communication barriers between NJH and Muncy staff, the need for peer support, and offering additional NRT. Pennsylvania is currently reviewing the findings from the pilot evaluation to determine the feasibility of expanding this program statewide.