Cigarette smoking among college students with disabilities: National College Health Assessment II, Fall 2008-Spring 2009

Individuals with long-term illness, disability or infirmity are more likely to smoke than healthy controls: An instrumental variable analysis

Despite the prevalence of smoking cessation programs and public health campaigns, individuals with long-term illness, disability, or infirmity have been found to smoke more often than those without such conditions, leading to worsening health. However, the available literature has mainly focused on the association between long-term illness and smoking, which might suffer from the possible bidirectional influence, while few studies have examined the potential causal effect of long-term illness on smoking. This gap in knowledge can be addressed using an instrumental variable analysis that uses a third variable as an instrument between the endogenous independent and dependent variables and allows the identification of the direction of causality under the discussed assumptions. Our study analyzes the UK General Household Survey in 2006, covering a nationally representative 13,585 households. We exploited the number of vehicles as the instrumental variable for long-term illness, disability, or infirmity as vehicle numbers may be related to illness based on the notion that these individuals are less likely to drive, but that vehicle number may have no relationship to the likelihood of smoking. Our results suggested that chronic illness status causes a significantly 28% higher probability of smoking. The findings have wide implications for public health policymakers to design a more accessible campaign around smoking and for psychologists and doctors to take targeted care for the welfare of individuals with long-term illnesses.

The Factors Associated with Attempted Smoking Cessation and Successful Four-Week Smoking Abstinence According to the Types of Disability in Seoul, Korea

This study investigated smoking behaviors by disability type among people with disabilities in Korea and identified factors associated with attempted smoking cessation and successful four-week smoking abstinence. Data were collected between 1 January 2018 and 31 December 2019. Predictors of attempted smoking cessation and successful four-week smoking abstinence were analyzed by disability type in 557 participants. Compared to people with mental health disorders, people with physical disabilities or brain lesions were more likely to attempt smoking cessation, and people with physical or internal disabilities were more likely to successfully abstain for four weeks. Common predictors of smoking cessation attempts and four-week abstinence were education level and CO level. Employment status predicted attempted cessation, while confidence in smoking cessation predicted four-week abstinence. To provide effective smoking cessation services for people with disabilities, disability type should be considered, and comprehensive and sustainable community-based programs need to be developed. Furthermore, a standardized survey of people with disabilities should be conducted to examine socioeconomic factors, including health status, employment, and education level, and to explore fundamental measures needed to address the problem of smoking among people with disabilities.

Disparities in illicit drug use and disability status among a nationally representative sample of U.S. college students

BACKGROUND

The number of students with disabilities attending postsecondary institutions is increasing. However, research on substance use among this population is limited.

OBJECTIVE

This study examined disparities in the prevalence of illicit drug use and drug use disorders among college students with disabilities and their counterparts without disabilities.

METHODS

Data from the 2017 National Survey on Drug Use and Health were analyzed. We estimated prevalence and odds of disability, illicit drug use, and illicit drug dependence or abuse in a subsample of college students (n = 6,189).

RESULTS

A majority of college students reporting a disability had a cognitive limitation. Students with any disability had a higher prevalence of illicit drug use and significantly higher odds of ever use of illicit drugs (AOR = 1.47; 95% CI 1.20-1.79). Compared to their peers with no disabilities, they were more likely to have misused any psychotherapeutic in the past year (AOR = 1.38; 95% CI 1.08-1.76), and had nearly twice the odds of misusing prescription pain relievers in the past month (AOR = 1.97; 95% CI 1.11-3.49). Additionally, students with disabilities had three times the odds of meeting criteria for past-year dependence or abuse of any illicit drug (AOR = 3.01; 95% CI 2.06-4.40).

CONCLUSION

This study documented a higher prevalence of drug use and drug use disorders among college students with disabilities compared to their nondisabled peers. Understanding the risk factors for substance use in this population is critical for developing effective prevention and treatment strategies.

Smoking among adults with and without disabilities in the UK

Background

The health risks of cigarette smoking are well established. As a result, reducing cigarette smoking is a key concern for public health agencies. Little is known about rates of smoking among adults with disabilities.

Methods

Secondary analysis of data collected in Waves 2 and 7 of 'Understanding Society', an annual household panel study.

Results

Age and gender adjusted odds ratios (AORs) of adults with disabilities smoking increased significantly from 1.41 (1.33-1.49) in 2010-12 to 1.57 (1.45-1.70) in 2015-17 (P = 0.032). AORs of adults with disabilities smoking 20 or more cigarettes a day increased non-significantly from 1.83 (1.66-2.02) in 2010-12 to 1.90 (1.65-2.20) in 2015-17. These changes were evident for both men and women and across age groups. Additionally adjusting these estimates to take account of between group differences in socioeconomic position significantly reduced the AORs for both smoking outcomes. Changes over time in AORs reflected a more rapid decline in smoking among participants without a disability.

Conclusions

Adults with disabilities are more likely than their peers to smoke. Public health agencies and practitioners may wish to consider what reasonable adjustments may need to be made to policies and interventions to ensure that they are effective for adults with disabilities.

Physical Mobility Impairment and Risk for Cardiovascular Disease

Background: People with disabilities (PWD) often self-report reduced access to preventive health services and poorer health than people without disability. Risk factors for chronic disease are more prevalent in PWD, increasing risk for secondary conditions including cardiovascular disease (CVD). Methods: Logistic regression was used to analyze data from the 2016 Behavioral Risk Factor Surveillance Survey to explore the relationship between disability with mobility impairment and CVD. Results: Difficulty walking and climbing stairs significantly predicted concomitant CVD and diabetes in logistic regression models. Conclusion: Information from this study may be useful in addressing CVD risk for adults with mobility impairments.

Psychometric properties and a latent class analysis of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in a pooled dataset of community samples

The 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a brief measurement tool used cross-culturally to capture the multi-dimensional nature of disablement through six domains, including: understanding and interacting with the world; moving and getting around; self-care; getting on with people; life activities; and participation in society. Previous psychometric research supports that the WHODAS 2.0 functions as a general factor of disablement. In a pooled dataset from community samples of adults (N = 447) we used confirmatory factor analysis to confirm a one-factor structure. Latent class analysis was used to identify subgroups of individuals based on their patterns of responses. We identified four distinct classes, or patterns of disablement: (1) pervasive disability; (2) physical disability; (3) emotional, cognitive, or interpersonal disability; (4) no/low disability. Convergent validity of the latent class subgroups was found with respect to socio-demographic characteristics, number of days affected by disabilities, stress, mental health, and substance use. These classes offer a simple and meaningful way to classify people with disabilities based on the 12-item WHODAS 2.0. Focusing on individuals with a high probability of being in the first three classes may help guide interventions.

A systematic review of tobacco use among adolescents with physical disabilities

OBJECTIVE

To provide a systematic review of tobacco use among adolescents with physical disabilities.

STUDY DESIGN

A systematic review.

METHODS

A search was performed of English articles published prior to December 2014 in the PubMed database for studies examining smoking rates among adolescents with and without physical disabilities. Ten studies were retrieved (all cross-sectional surveys) of which six compared adolescent populations from nationally representative samples and four examined those based on convenience sampling. Pooled analyses of smoking rates by disability status were performed.

RESULTS

In studies from nationally representative samples (n = 6 studies), adolescents with physical disabilities were significantly more likely to use tobacco as compared to adolescents without (pooled analyses = 29.7% vs 23.3%). However, in studies from non-representative samples, adolescents with physical disabilities were less likely to use tobacco as compared to adolescents without (pooled analyses = 22.7% vs 39.1%).

CONCLUSIONS

Adolescents with physical disabilities may have an increased risk of tobacco use relative to those without disabilities. Tailored tobacco use prevention and cessation strategies may be appropriate for this high-risk population. Future longitudinal studies which determine factors associated with tobacco use among adolescents with different disabilities should be considered to reduce the disproportionate tobacco use in this population.

Smoking behaviors among people with disabilities in Korea

BACKGROUND

Most reports concerning smoking behaviors in people with disabilities have been from Western societies; knowledge of smoking behaviors in Asian countries, including Korea, is insufficient.

OBJECTIVES

This study investigates the smoking behaviors of people with a disability compared to the general population in Korea.

METHODS

We compared the smoking behaviors of people with a disability with the general population by using datasets from the 2011 National Survey of Disabled People and an age- and sex-matched random sample from the 5th Korean National Health and Nutrition Examination Survey. Random samples of people 18 years of age and older with disabilities (n = 5636) and of the general population were used (n = 5636). The main outcome measures include smoking behaviors by type, severity, and age at disability onset.

RESULTS

People with a mental or physical impairment have higher current smoking rates (38.1% and 26.3%, respectively) than the general population (23.3%). In particular, current smokers with psychiatric impairment were more likely to smoke more than 20 cigarettes a day (61.2%). People with a disability, regardless of severity or age at onset, were less likely than the general population to have attempted to quit smoking.

CONCLUSIONS

Smoking behaviors differed according to the type of disability. These results suggest that interventions for smoking prevention and cessation need to be tailored according to disability characteristics.