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

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 examines tobacco consumption profiles, oral health outcomes, and motivation to quit among inmates in a central prison in Navi Mumbai, India. 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: 53.1% of the inmates used tobacco products, with 39.5% consuming smokeless forms. Dental caries prevalence was 43%. Periodontal disease was observed in 46.04% of participants, with both conditions significantly associated with tobacco use (p < 0.001). Oral mucosal lesions were reported in 2.6% of the study population. Additionally, 76.3% of tobacco users expressed willingness to quit, though only a small proportion had access to cessation programs or support. 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.