Researchers who set out to determine the mortality attributable to smoking and years of potential life lost from smoking among people in prison — and whether bans on smoking in prison are associated with drops in certain types of deaths — found prison smoking bans are associated with a substantial reduction in deaths from smoking-related causes, such as heart disease and cancer.

The study, published on The BMJ, found that smoking-related deaths were cut significantly in state prisons with long term bans in place. Prisons that implemented smoking bans had a 9% reduction in smoking related deaths. Bans in place for longer than nine years were associated with 11% reductions in all smoking related deaths, a 19% reduction in cancer deaths, and a 34% reduction in pulmonary deaths compared with places with no ban.

Their results are based on surveys of inmates in state correctional facilities and data on state prison tobacco policies and deaths in prisons across the United States.

US prisons have increasingly implemented smoking and tobacco bans, but the effects of smoking on mortality and the health benefit of these policies had not been evaluated. England and Wales are also implementing or considering complete bans on smoking in prison.

At the end of 2011 in the US, there were 1.4 million people in state prisons: 50 to 83% of people in prison smoke, substantially higher than the general population outside prison; and the most common deaths for prison smokers are lung cancer, heart disease, stroke, and chronic lung disease.

In prisons, smoking attributable mortality and years of potential life lost rates were 360 and 5,149 per 100,000, respectively. These figures are higher than rates in the general US population (248 and 3,501 per 100,000, respectively).

The number of states with any smoking ban increased from 25 in 2001 to 48 by 2011. In prisons, the mortality rate from smoking related causes was lower (110 per 100,000) during years with a ban than during years without a ban (129 per 100,000).