Smoking status and the presence of chronic obstructive pulmonary disease in prison

J Addict Med. Mar-Apr 2015;9(2):118-22. doi: 10.1097/ADM.0000000000000103.


Introduction: Smoking, with a prevalence ranging from 42% to 91%, and secondhand smoke (SHS), with a high exposure level of 3 to 11 μg/m, are frequently seen in prisons.

Objectives: We aimed at investigating the prevalence of chronic obstructive pulmonary disease (COPD) among inmates and prison staff.

Material and methods: This study included prisoners and prison staff in Bolvadin Closed and Open Prison in Turkey. All volunteers went through a standard spirometry and completed the Fagerstrom Test for nicotine dependence.

Results: A total of 179 volunteers, 109 of whom were prisoners and 70 prison staff, were involved in the study. Average age was 35.6 ± 11.9 years. There were 123 smokers (68.7%), 26 ex-smokers (14.5%), and 30 nonsmokers (16.8%). Up to 89.4% of participants reported that they were exposed to SHS. Mean forced expiratory volume in 1 second (FEV1) value was found to be 3.68 ± 0.80 (93.9 ± 15.1%), forced vital capacity (FVC) value to be 3.87 ± 0.83 (83.1 ± 14.3%), and FEV1/FVC to be 98.4 ± 19.6. Eighteen inmates and 2 prison staff members had the diagnosis of COPD; 22 prisoners (20.2%) and 4 prison staff members (5.7%) had COPD. There were pulmonary symptoms in 49.2% of the volunteers; the symptoms were statistically higher in smokers when compared to non-smokers and ex-smokers (P = 0.000). There was a statistically significant relationship between exposure to SHS and presence of COPD (P = 0.043), and pulmonary symptoms (P = 0.008).

Conclusions: The frequency of smoking in this prison was considerably high (68.7%, compared against 22%-31% in non-incarcerated populations). The prevalence of COPD was also found high among inmates (20.2% vs 4.2%-23% in non-incarcerated populations). Therefore, pulmonary symptoms should be examined carefully when screening prisoners, including consideration for the use of lung spirometry and screening for tobacco use disorder.

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Occupational Diseases / epidemiology*
  • Prevalence
  • Prisoners / statistics & numerical data
  • Prisons / statistics & numerical data*
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Smoking / epidemiology*
  • Tobacco Smoke Pollution / adverse effects
  • Turkey / epidemiology
  • Young Adult


  • Tobacco Smoke Pollution