Smoking Status and the Presence of Chronic Obstructive Pulmonary Disease in Prison

Introduction: Smoking, with a prevalence ranging from 42% to 91%, and secondhand smoke (SHS), with a high exposure level of 3 to 11 mu g/m(3), 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 nonincarcerated populations). The prevalence of COPD was also found high among inmates (20.2% vs 4.2%-23% in nonincarcerated 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.