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Approximately 70% of incarcerated people smoke tobacco, and an estimated 12% of all smokers in the United States leave correctional facilities annually. Many facilities prohibit smoking, but no published study has measured the relapse to tobacco after release. In a study of 200 people with chronic health conditions reentering the community from jail, 165 (83%) were cigarette smokers. Of these, 129 were interviewed at 1 and/or 6 months after release. Self-reported sustained abstinence rates were 37.3% at the end of the first day, 17.7% for the first week, 13.7% for 1 month, and 3.1% for 6 months. These abstinence rates are lower than those reported after military basic training and medical hospitalization but similar to rates after inpatient psychiatric and addiction programs. More efforts and resources are needed to determine successful tobacco cessation interventions during incarceration and after release.

A cooperative, community-oriented "public health model of correctional healthcare" was developed to address the needs of persons temporarily displaced into jail from the community, and to improve the health and safety of the community. It emphasizes 5 key elements: early detection, effective treatment, education, prevention, and continuity of care. In the program, physicians and case managers are "dually based"-they work both at the jail and at community healthcare centers. This, together with discharge planning, promotes continuity of care for inmates with serious and chronic medical conditions. This report characterizes the health status and healthcare in this group, and identifies facilitators and barriers to engagement in primary medical and mental health care after release from jail.

U.S. prisons and jails have the nation's highest concentration of individuals infected with and at risk for HIV infection. Many correctional institutions offer 1-HIV care, but advances are oftentimes lost when individuals with a lack of health insurance and access to care are released into the community. In 1999 the Centers for Disease Control and Prevention and the Health Resources and Services Administration jointly funded seven health departments to address this need. These projects target soon-to-be-released inmates of jails, prisons, and juvenile facilities and offer enhanced discharge planning, case management, HIV prevention, disease screening, and staff training. The Evaluation and Program Support Center (EPSC) at Emory University and Abt Associates was funded to oversee a cross-site evaluation of these demonstration projects. This paper describes the process of developing a cross-site evaluation, the implementation of this evaluation, and lessons learned by the EPSC throughout this process.

The article reflects on the Center for Disease Control and Prevention (CDC) Rapid HIV Testing in Jail Demonstration Project and rapi HIV testing in jails. He states that after the success of the CDC demonstration project at demonstrating that rapid testing is feasible in jails, the challenge to prisons, public health departments, and acquired immune deficiency syndrome service organizations is to fill the gaps in knowledge on how to operationalize rapid HIV testing in jails on a larger scale.