Current tobacco policies in U.S. adult male prisons☆

Current tobacco policies in U.S. adult male prisons☆

The Social Science Journal 38 (2001) 27–37 Current tobacco policies in U.S. adult male prisons夞 Steven Patrick*, Robert Marsh Department of Sociology...

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The Social Science Journal 38 (2001) 27–37

Current tobacco policies in U.S. adult male prisons夞 Steven Patrick*, Robert Marsh Department of Sociology, Boise State University, Boise, ID 83725, USA

Abstract The current national trend in the restriction of smoking and use of tobacco products is extending to the prison system. At the same time that city, state and the federal governments are limiting smoking in public places and businesses, state and federal prison systems are limiting use in correctional facilities. The data for this paper was collected by mail from departments of correction in the fifty states, the District of Columbia and the federal Bureau of Prisons. The results show a continuing trend in tobacco limitation policies at male prisons within the U. S. Several states totally ban all tobacco and only a few still allow generally unlimited use. Limitation policies range from segregation into smoking and nonsmoking areas to the banishment of inmates and staff to smoking areas outside prison buildings. While many see a nonsmoking prison system as the wave of the future, use of tobacco in prisons is still common. This research examines the official reason given for changes in tobacco policy and the alterations in prison operations that developed after restrictions were implemented. Increased tensions developed among inmates, staff and administration as a result of the new policies. For those prison systems that banned tobacco, an active black market operation developed eclipsing other contraband problems. © 2001 Elsevier Science Inc. All rights reserved.

1. Introduction Smoking and the use of tobacco products are increasingly under attack throughout society (CDC, 1994). Yet until the Surgeon General’s Report (1964) associating tobacco products with cancer, there was little attempt to discourage the use of tobacco. In the twenty years after the report was issued government activism developed to inform the public of the health

夞The information in the article was presented at the 1997 American Society of Criminology. * Corresponding author. Tel.: ⫹1-208-426-3225. E-mail address: [email protected] (S. Patrick). 0362-3319/01/$ – see front matter © 2001 Elsevier Science Inc. All rights reserved. PII: S 0 3 6 2 - 3 3 1 9 ( 0 0 ) 0 0 1 0 8 - 7

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hazards of smoking. This took the form of increasingly explicit warnings on tobacco products and their potential risks to the user (Vaughn & del Carmen, 1993a; Johnson & Cintron, 1996). In 1986, the strategy of the government shifted from explicit warnings on use of tobacco products to proclaiming the dangers of environmental tobacco smoke (ETS) on nonsmokers. The dangers of ETS was documented in a Surgeon General’s Report entitled The Health Consequences of Involuntary Smoking (1986). In this report the researchers discussed the impact of “second-hand” smoke on nonsmokers and provided evidence that the nicotine content of passive smoke and subsequent dangers to nonsmokers were significant. In 1989, the strategy of the US government escalated again from one of education and warnings on tobacco products to aggressively attempting to create a smoke-free society by the year 2000 (Vaughn & del Carmen, 1993a). This 1986 report aggressively pointed out the economic costs of smoking and mortality rates of smokers. The Surgeon General’s Report (1986) estimated that 17% of all deaths in the United States were preventable if the country was entirely “smokeless.” The media was actively discussing the new “war on tobacco” by 1988 (Johnson & Cintron, 1996). Because of this increasingly aggressive attack on tobacco use and smoking there have been a plethora of new restrictions in numerous venues including the workplace, restaurants, bars and in retail establishments across the United States. Smoking has gone from a socially acceptable and benign behavior throughout most of this century to a “nationally notifiable condition” (CDC, 1996). This special status designates cigarette smoking as one of the leading “preventable causes” of death in the United States. Government has progressed from promoting rather benign laws to separated smokers and nonsmokers in public venues to actively discouraging use and consideration of prohibition under the Federal Drug Administration (FDA). Although smoking restrictions have been confined to the areas frequented by the general public and in the workplace environment, this movement has also penetrated one of the most restrictive environments in the society, the nation’s prison systems. While prisons are acknowledged as a place for punishment and correction, they are unique from other areas in society because inmates are confined totally to the prison environment. While they may eat, work, attend educational classes, and treatment sessions within the confines of the prison, they also reside in the prison. Inmates suffer a serious deprivation of liberty in prison but the use of tobacco in adult prisons has been permitted throughout most prisons. In free society, restrictions on tobacco use impact public areas but, as of yet, not private residences. Prisons are a microcosm of society in many significant ways yet, they differ significantly in the organization of the prison and the prison culture (Clemmer, 1958). Erving Goffman, characterized the prison as a “total institution” (1966). He argued that persons in total institutions were isolated both physically and symbolically from general society. When this isolation comes as the result of behavior considered to be dangerous to free society, the welfare of the inhabitant is not a particular concern (Goffman, 1966)

2. Literature review The history of tobacco in US prisons is a history driven by economics, public policy, research on tobacco use, public sentiment and punishment. Throughout much of the 80’s

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research on smoking in prison centered on the traditional policy of supplying inmates with free tobacco (Romero & Connell, 1988). Tobacco provided an important commodity for personal use and as the “currency” of the inmate economy. Questions regarding the right to possess and use tobacco were not raised. In the late 80’s the use of tobacco products was not in questions but by the early 90’s, a movement to restrict tobacco use had begun. Much of the debate on tobacco use in prison was driven by an economic argument. A rapidly escalating prison population and the strain on local, state, and federal budgets created a desire to constrain prison costs (Austin & Irwin, 1997). One significant area of cost was that of health care for a rapidly increasing population that was aging and beset by a number of serious diseases such as tuberculosis, hepatitis, and AIDS. Prison administrators were seriously impacted by rising health care costs (Vaughn & del Carmen, 1993a). Again, the Surgeon General offered data to reduce tobacco use in a report entitled The Health Benefits of Smoking Cessation: A Report to the Surgeon General (1990). Since research indicated that inmates used tobacco in greater numbers than the general population, increasing costs of corrections in general and health care costs in particular were a concern for administrators (Vaughn & del Carmen, 1993a). It was clear that significant amounts of tax dollars could be saved if smoking (by both inmates and correctional employees) could be eliminated from prisons (Romero & Connell, 1988). Inmate and employee health care costs were significantly impacted by the close, restrictive environment of prisons and jails for both smokers and nonsmokers (Romero & Connell, 1988). Romero and Connell (1988) suggested that inmate health care costs are twice as high as the general population. Because of the health care concerns and the associated costs of health care both the American Correctional Association and the American Jail Association adopted resolutions to eliminate tobacco use in jails and prisons in 1990 (American Correctional Association, 1990; Vaughn & del Carmen, 1993a). By the mid-1990s, the focus had changed to an “individual rights’ debate regarding smokers and nonsmokers (Vaughn & del Carmen, 1993a; Vaughn & del Carmen, 1993b). This shift in both public attitudes and correctional policy was also influenced by a significant Supreme Court case in 1993 regarding second-hand smoke (Helling & McKinney, 1993). In this case an inmate filed a suit against the Nevada Department of Corrections because he was housed in a small cell with a chain-smoker. The case was eventually appealed to the US Supreme Court and McKinney’s claim that confinement with a smoker and being exposed to second-hand smoke was ”cruel and unusual punishment“ and potentially injurious to his health. The Court upheld his claim by a 7–2 majority (Helling & McKinney, 1993). ”Deciding for the prisoner, the Court said that exposure to unreasonably high levels of ETS may sometimes be cruel and unusual punishment (Vaughn & Del Carmen, 1993c: 34).“ Vaughn and Del Carmen (1993c) noted that this decision clarified a number of other confusing and contradictory decisions on smoking in correctional environments. ”Prior lower court case law on smoking in prisons falls into three categories: cases that upheld smoking bans, cases that denied inmates’ requests for a smoke free environment, and cases that granted inmates’ requests for a smoke free environment (Vaughn & del Carmen, 1993c: 35).“ The Supreme Court decision helped to solidify a ”movement“ begun with the 1964 Surgeon General’s Report to discourage tobacco use to outright constitutional right to be in a smoke-free environment.

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Table 1 Current smoking/tobacco policies Policy

Number of states

Total Ban on smoking and/or all tobacco Limited Smoking and/or all tobacco Unlimited Smoking

7 (13.5%) 44 (84.6%) 1 (1.9%)*

* Plans to ban smoking next year.

In the last part of this decade the movement has again changed to not only limit tobacco but to prohibit it entirely. The purpose of this research is to chronicle the current policies at US adult male prison, discover the extent of the restrictions, and document the official reasons for restrictions and results of policy changes that have occurred.

3. Methods During September of 1996, 52 surveys were mailed to the Directors of Departments of Corrections in the fifty states, the District of Columbia, and the Federal Bureau of Prisons requesting information on current tobacco policies. This survey included questions on all tobacco products. After several weeks a second mailing was sent to nonrespondents. All 52 subjects responded, although two refused to provide information by mail. Basic information on the two mail refusals was obtained from phone interviews. (These two subjects refused to respond in writing due to current court litigation against the tobacco industry or due to current changes in tobacco policy.) The respondents to the survey ranged from the Directors of Corrections for the state to Wardens. Some respondents simply filled out the survey while a few sent along official policy documents to clarify statements.

4. Findings While a large number of questions were asked, this paper will focus on current policies, rationales for the policies and impacts of the policies. We will first examine the rationales and impacts. 4.1. Current policies According to Vaughn and del Carmen (1993a), in 1993 there were no prisons in the US that banned smoking entirely. By 1996, seven prison systems had banned smoking1 and three of the seven have banned all tobacco products. As shown in Table 1, seven or 13.5% of the 52 respondents (departments) have completely banned smoking. Forty four of the respondents have placed limits, sometimes extreme, on where inmates and/or staff can smoke. One respondent claimed that currently inmates and staff can smoke anywhere but commented that they plan to ban all smoking in the near future. It should be noted that 70% of the respondents

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Table 2 Official reasons for alteration of tobacco policies Banned Tobacco (N ⫽ 7) To Avoid Litigation To Avoid Legislation To Reduce Health Costs Other

1 4 5 0

14.3% 57.1% 71.4%

Limited Tobacco (N ⫽ 44) To Avoid Litigation To Avoid Legislation To Reduce Health Costs Other

7 14 18 16

15.9% 31.8% 40.9% 36.4%

Are There Inmates to which the Policies Do Not Apply? Banned Tobacco (N ⫽ 7) Yes

5

71.4%

Limited Tobacco (N ⫽ 44) Yes

4

9.1%

have changed their tobacco policies in the past 4 years. This fact alone speaks to the importance and timeliness of the current research. 4.2. Reasons for current policies Previous research indicated that as many as 75% of inmates use tobacco (Patrick, 1996). This is almost the opposite of the general population (National Center for Health Statistics, 1998). Inmate smokers are the majority in most prisons and some correctional officers have claimed that tobacco is as important as television in terms of inmate management (Patrick, 1996). Under these circumstances one might question why prison systems would ban smoking. The survey requested information on why the respondents choose to ban or limit smoking. The results of these questions appear in Table 2. For those respondents that have completely banned smoking two factors seem to predominate. First, many respondents commented that the state has passed laws limiting smoking in state owned and run facilities.2 Tobacco policies were changed in response to or anticipation of these legislative actions. The second major reason for banning smoking was to reduce, or control inmate healthcare costs. For those respondents that have only limited smoking, the responses in the survey were generally the same with one significant exception. While none of those systems that banned smoking had other comments, over 36% of those who limited smoking wrote in other comments. These comments generally concerned attempts to reduce both building and maintenance costs in operating the prisons. This fits well with attempts to reduce medical costs. Prisons are growing and are coming under more pressure to constrain costs as they become an every greater proportion of state budgets. Prison populations and subsequent costs have risen exponentially in the last two decades. Between 1985 and 1996 total inmates in custody increased by 119.2% (Proband, 1997b). The

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Table 3 What were the results of these tobacco policy changes Banned Tobacco (N ⫽ 7) Increased Inmate-Inmate Tensions Increased Inmate-Staff Tensions Increased Staff-Administration Tensions Increased Contraband Increased Violence Increased Litigation Decreased Litigation Increased Visits to Sick Call Decreased Visits to Sick Call

2 1 2 5 1 0 0 1 1

28.6% 14.3% 28.6% 71.4% 14.3%

Limited Tobacco (N ⫽ 44) Increased Inmate-Inmate Tensions Increased Inmate-Staff Tensions Increased Staff-Administration Tensions Increased Violence Increased Litigation Decreased Litigation

8 10 11 1 5 4

18.2% 22.7% 25.0% 2.3% 11.4% 9.1%

14.3% 14.3%

annual growth rate from 1995– 6 was 5% in prisons under jurisdiction of state or federal correctional authorities (Proband, 1997b). In FY97 correctional budget requests led state budget requests with an average of 6.3% throughout the US (Proband, 1997a). Tobacco has a long history in America, especially with Native Americans (Robert, 1967). For those states that have banned tobacco, over 71% have made exception for tobacco use in Native American religious rituals. This exceptions can be explained partially by the Native American Religious Freedom Act of 1978 (Marsh & Cox, 1994). In a national survey of religious practices allowed in prison, eight states allowed sweat lodges which included the religious ceremonial use of tobacco (Marsh & Cox, 1994). Even 9% of those limiting smoking have excepted Native Americans from some aspects of their limitations. 4.3. Results of these tobacco policies When major changes occur, often suddenly, in the structure of tightly controlled systems problems can occur (Patrick, 1996; Perrow, 1994). Tobacco use is an addictive habit and in forcing large numbers of individuals to quit smoking, often without any assistance, any number of control issues can arise. As noted by DiIulio (1987) prison administrators must work within the context of the “inmate society” and hope that inmate’s behavior will voluntarily conform to institutional rules. “Inmates must be coaxed, not coerced” (DiIulio, 1987: 19). The stated results of the smoking bans and limitations appear in Table 3. For respondents who banned smoking several issues arose. First, as expected, tensions rise between various groups within the prison. The two sets of groups experiencing the most problems are inmates v. inmates and staff v. administration. Curiously, increased violence does not seem to be the major problem one might expect.3 This may be partly explained by the increase in contraband tobacco smuggled into the prison and modification of the inmate economy. It appears that in many cases inmates and staff have not stopped smoking but

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Table 4 What are the range of limits on tobacco 41% have smoking and nonsmoking housing units Allow Smoking in Cells Allow Smoking in Recreation Areas Allow Smoking in Administration Areas Allow Smoking in Cafeteria Allow Smoking in Dayrooms Allow Smoking in Visiting Areas Allow Smoking in Chapel Allow Smoking Outside Other

23 7 1 2 17 4 1 40 19

52.3% 15.9% 2.3% 4.5% 38.6% 9.1% 2.3% 90.9% 43.2%

created a new “illegal and lucrative” industry within the prison. An interesting side effect of the dramatic increase in tobacco smuggling is a sharp decline in contraband including other drugs. This is primarily being driven by a policy that has dramatically increased the value of a commodity in prison that is legal and easily obtainable in society. It also speaks strongly to the addictive power of tobacco as compared to other drugs (Center for Disease Control, 1996). At this early stage the medical results of a smoking ban have not been seen. If inmates quit smoking (although it appears that they have not), time should show a reduction in sick call visits (Bridgwood & Malbon, 1995). For the respondents who limited smoking, the tension increases are comparable to those that banned tobacco. Some commented in the open ended questions that contraband had increased and the costs associated with it. It seems that for those that limit smoking some will experience increases in inmate litigation and others will experience decreases in law suits filed by inmates. This may be related to the extent of the limitation and the way it is enforced (Vaughn & Del Carmen, 1993c). 4.4. Designated smoking areas in limited smoking systems For departments that have limited smoking, the variety of restrictions is great. Forty one percentage of those that limit smoking have segregated smokers and nonsmokers by housing unit. Beyond this, over half allow inmates to smoke in their cells and over 38% of the respondents have extended this to the housing dayrooms. A small number of respondents stated that various areas were designated where inmates and/or staff were allowed to smoke. The vast majority of these allowed smoking outside or even limited it to outside. The category of other consisted mostly of special areas or rooms set aside explicitly for smoking.

5. Discussion and policy implications Smoking in prison is under attack for many of the same reasons that tobacco use is under attack in the US and around the world. The limitation of tobacco use is interpreted as a way to reduce costs, increase productivity of staff and prison industries, respond to changes in

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state and federal law, and because of public health concerns. Considering this, it is somewhat surprising that more states have not banned smoking in correctional environments. In any case the current trend is well established and well supported. In the late 1980s costs were an issue in supplying inmates with free tobacco. In the early 1990s litigation and legislation were the driving force in smoking limitations. By the late 1990s banning tobacco is being seen as a way to lower costs of litigation, construction, maintenance, and healthcare. It seems clear that, barring significant changes in the social and political atmosphere, the movement to ban tobacco use in prisons will continue. Tobacco restriction policies satisfy constituencies that wish to improve the lives of inmates with the health benefits and at the same time satisfy those who wish to “get tough” on criminals by taking something else away from them. They can do all this while at the same time reducing the apparent cost of corrections at a time when the public is beginning to question the ever increasing costs of corrections (Proband, 1997a). Banning smoking is smart politically. While smoking bans will increase, the policy implications of these bans are serious. Some prisons ban smoking to reduce costs but this cost reduction is dependent upon inmates and staff actually quitting smoking. From discussions with staff at several prisons, and comments returned on the survey, it appears that smoking does not cease when tobacco is banned even years after the ban takes affect. If smoking cannot be eliminated in the restrictive correctional environment the cost benefits sought will not materialize. Additionally, any ban on tobacco will create a whole new set of issues that have serious implications for prison administration. These implications include morale and control issues involving staff and inmates. Smoking is highly addictive requiring frequent infusions of nicotine or withdrawal symptoms will result. With up to 75% of inmates smoking before bans were implemented, a reduction of 25% will still result in a majority of inmates who need tobacco. Tobacco is an ambiguous drug. In society where it is legal to buy and use tobacco, it is very unlike other “drugs.” It is also a “drug” that over a quarter of the correctional officers use or have used. Tobacco in prisons that ban smoking brings high prices on the black market. The survey indicated that in minimum security facilities the going rate for a single cigarette is up to 3 dollars. The price rises to 10 dollars in medium security facilities and can reach 30 dollars per cigarette in maximum security facilities. These prices will drive a contraband market unlike any other. While inmates will smuggle tobacco, as they do all other illegal substances, the nature of tobacco will bring many staff members into the contraband network who would never consider smuggling other drugs. Discussion with staff and survey responses points out that staff are the major source of illegal tobacco in prisons. It was reported in the survey that one staff teacher made $18,000 in a few months smuggling cigarettes and a correctional officer actually started a fight with an inmate over nonpayment of funds for smuggling. Both of these examples where caught by the administration but neither were prosecuted and resulted in resignations. Aside from the illegality of these actions, tobacco bans can and will bring prison staff into the inmate subculture. Once this line is crossed other lines may be crossed. This has significant implications for prison administration. While only a small number of staff may smuggle, these numbers will be large compared to those staff smuggling other drugs. This will create dependence of staff on inmates that will undermine the authority structure of the prison. Additionally, staff smuggling will undermine the morale of staff that do not smuggle creating alienation of staff from

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other staff. The only way to minimize smuggling is to search every staff as they enter the prison and prosecute those that smuggle. This will slow the smuggling but will alienate the staff from the administration which is almost as disruptive to order as staff alienation from other staff. Even staff who do not engage in smuggling will make use of illegal tobacco. Inmate management is the central role of the first line correctional officer. Correctional officers want and need inmate cooperation. This need will even precede the need to follow the formal rules of the prison. For those inmate who cooperate small rule violations can and will be overlooked and this will include tobacco violations. For those inmates who do not cooperate tobacco violations will be used to punish and remove them from the general population. In addition to the problems with staff smuggling, or even just looking the other way, inmates will actively engage in smuggling. Tobacco has historically been the currency of the inmate subculture and will become more so with tobacco bans. As prices rise some inmates will quit smoking but others will tap into resources, family and friends, outside the prison for funds. Still others will resort to violence either in procuring tobacco or in collecting the revenues produced by selling tobacco. Two prisons in the survey at one time had tobacco bans but converted the ban to limitations due to dramatic increases in violence after the bans. Prisons are becoming more violent places and tobacco bans will increase this trend. Increased violence will increase cost in multiple ways from increased staffing to medical costs associated with inmate and staff injuries. It may be impossible to stop inmates, or even staff, from using tobacco. Until tobacco is banned in society and the punishments for smuggling are greatly increased, to the levels of illegal drugs, tobacco will remain common even in prisons with tobacco bans. Limiting tobacco may, for the foreseeable future, be the most effective method. Limiting smoking to outside will have two significant affects. First, the contraband problem will be stopped. If tobacco is only limited then the costs of tobacco will remain low for inmates and smuggling will not be lucrative for vendors or staff. Second, if smoking is limited only to outside the use of smoking as an inmate management tool for correctional officers will remain. Inmates that are uncooperative can be punished for smoking inside and the actions of those that cooperate will be overlooked just a with a total ban. Additionally, limited smoking to outside will eliminate any official problems of second hand smoke. This may reduce inmate litigation and may even reduce some health and maintenance costs.

6. Conclusions It appears that the societal movement to prohibit smoking is being reproduced in the nation’s prison systems. A mere four years ago no prison banned smoking entirely, yet today, virtually all ban or restrict it. There are many reasons for discouraging people from using tobacco but the results this study indicate that absolute prohibition is problematic in the correctional setting. The topic of smoking will continue to be controversial and more research on this topic is needed. In addition to collecting information on policy we need to investigate and understand the reasons behind these changes and the long-term impact on

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staff, inmates, and the correctional system. The negative implications on staff, inmates and the correctional system in general from a ban may be greater than the perceived benefits.

Notes 1. The number of prison banning smoking has been reported to be as high as 13 but this number includes systems planning to ban smoking and/or systems that ban smoking in a limited number of facilities. This report defines only those systems that currently ban smoking system wide to be nonsmoking systems. 2. Several of the states that have banned smoking also have privately run prisons. These privately run prisons are not, in most cases, under state law concerning smoking and many allow smoking by inmates and staff. 3. One respondent among those limiting smoking stated that they had banned smoking but increased violence resulted in a rescinding of that ban and a limiting of smoking to outside only. With this the violence declined.

Appendix A Tobacco policy survey

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