The use of tobacco in prison leads to many long term health problems and more gang related activities for people who are incarcerated and for people who work at correctional facilities. This is a major problem within the correctional system because the escalating costs to keep inmates healthy and to rehabilitate them. The United States of America has the highest number of incarcerated people with guaranteed healthcare and a guarantee of minimum standards based on a state by state basis. This runs up the cost of living for the facilities due to the number of people with medical issues, a lot of these issues are tobacco related.
A lot of medical problems in prison can be directly linked to tobacco use inside and outside of prisons. In a brief called Tobacco Behind Bars: A Policy Options Brief there is a total of 2.3 million people behind bars as of March 2012. Of these people it is stated that 66.5 percent of state inmates and 51.5 percent of federal inmates with a substance abuse disorder had smoked tobacco in the month of their arrest. The brief also states that statistics show that lung cancer is by far the leading cause of cancers deaths among inmates which accounts for one out of three of all cancer related deaths. Of the deaths in state prisons, lung cancer results in more prison deaths then six cancers combined. These cancers are liver cancer, colon cancer, pancreatic cancer, non-Hodgkin’s lymphoma, prostate cancer and leukemia. The statistics are mind blowing when you sit down and actually realize how bad the effects of tobacco on the body medically are compared to almost anything else. It is estimated that between70 and 80 percent of all United States inmates smoke or use tobacco products. That is up to 4 times the national average. Smoking among incarcerated women ranges from 42 to 91 percent which is 2 to 4 times higher than women of general population. Prisoners are not generally the healthiest of the population due to the fact that many prisoners come from disadvantaged backgrounds with only limited or no opportunity to preventative health care or any health care over the years. (Tobacco Behind Bars) with the lack health care in their pre-institution lives the health care of the inmates falls on the institution and state to meet the 8th Amendment rights of the inmates. In a survey done by Prison Health Care Survey: An Analysis of Factors Influencing Per Capita Costs it states that certain screenings can be done to identify inmates with certain conditions, provide them the proper care, target them for education and prevention education, and, in some cases, place them in special units if their condition warrants. Although identifying inmates with conditions will increase health care costs at first, it may ultimately save money by limiting the spread of diseases. As of 1998, a survey of 49 states found that:
• 49 states provide tuberculosis screening;
• 24 states provide HIV/AIDS screening;
• 41 states provide STD screening;
• Eight states provide drug abuse screening;
• Eight states provide Hepatitis C screening; and
• 47 states provide basic physical and mental Health screenings.
These screenings are not free to the institution. The taxpayers have to pay for the screenings. Also after the screening they must pay for the care that the inmate may require. Given the high frequency of tobacco use by prison inmates there is an unsurprising amount of prison deaths directly related to tobacco use. Some of the diseases caused by tobacco are coronary heart disease multiple forms of cancer and chronic obstructive pulmonary diseases. With the amount of deaths and high health care costs related to tobacco use many states have put a ban on the use of tobacco in prisons. The problem with the tobacco products are the addictive properties of nicotine. An article in the New York Times called NICOTINE: HARDER TO KICK...THAN HEROIN, shows that Interdisciplinary research in pharmacology,