# Mapping Oral Health and Tobacco Risk Profiles Among Incarcerated Populations in a Central Prison of Navi Mumbai Using a Novel TRACE Framework—A Cross-Sectional Study

## TL;DR

This study examines tobacco use and oral health among prisoners in Navi Mumbai, India, revealing high rates of tobacco use and dental issues linked to it.

## Contribution

The study introduces a novel TRACE framework to assess tobacco use and oral health in incarcerated populations.

## Key findings

- Tobacco use was reported by 53.1% of inmates, with smokeless forms used by 39.5%.
- Dental caries and periodontal disease were significantly associated with tobacco use (p < 0.001).
- Despite 76.3% of users wanting to quit, access to cessation support was minimal.

## Abstract

Objectives: Tobacco-related habits, including both smoked and smokeless forms, remain a public health concern among incarcerated populations, where stress, stigma, and limited healthcare access contribute to high prevalence rates. This cross-sectional study was conducted among inmates in a central prison in Navi Mumbai, India and aimed to evaluate tobacco-use patterns, cessation motivation, and oral health outcomes among prison inmates in Navi Mumbai. Methods: A total population sampling technique was employed, which included 3321 out of 3333 inmates with varying durations of incarceration. Data were collected using a novel TRACE (Tobacco Use, Risk Factors, Assessment, Cessation, and Effects through Epidemiology) framework, incorporating the MTSS (Motivation to Stop Scale) and clinical assessments using the DMFT (Decayed, Missing, and Filled Teeth) index and OHI-S (Oral Hygiene Index-Simplified). Statistical analysis was performed using SPSS version 21 to explore associations between tobacco use and oral health outcomes in this vulnerable population. Results: Tobacco use was reported by 53.1% of inmates, with 39.5% using smokeless forms. Dental caries affected 43% and periodontal disease 46.0% of participants, both significantly associated with tobacco use (p < 0.001). Oral mucosal lesions were observed in 2.6% of inmates. While 76.3% of tobacco users expressed willingness to quit, access to cessation support remained minimal. Conclusion: These findings underscore the need for targeted interventions, such as in-house tobacco cessation programs and oral health services, in correctional facilities. Integrating cessation counseling into prison healthcare policies could improve outcomes among incarcerated populations.