Incarceration and Current Tobacco Smoking Among Black and Caribbean Black Americans in the National Survey of American Life.

Objectives: We examined the relationship between having a history of incarceration and being a current smoker using a national sample of noninstitutionalized Black adults living in the United States.

Methods: With data from the National Survey of American Life collected between February 2001 and March 2003, we calculated individual propensity scores for having a history of incarceration. To examine the relationship between prior incarceration and current smoking status, we ran gender-specific propensity-matched fitted logistic regression models.

Results: A history of incarceration was consistently and independently associated with a higher risk of current tobacco smoking in men and women. Formerly incarcerated Black men had 1.77 times the risk of being a current tobacco smoker than did their counterparts without a history of incarceration (95% confidence interval [CI] = 1.20, 2.61) in the propensity score-matched sample. The results were similar among Black women (prevalence ratio = 1.61; 95% CI = 1.00, 2.57).

Conclusions: Mass incarceration likely contributes to the prevalence of smoking among US Blacks. Future research should explore whether the exclusion of institutionalized populations in national statistics obscures Black-White disparities in tobacco smoking.