Nicotine - People Living With Disabilities

SMOKING INITIATION

2026: Functional disability and the risk of subsequent smoking initiation: A prospective cohort analysis

• Functional disability was independently associated with a higher risk of smoking initiation.
• Adults with two or more functional impairments had almost twice the risk of smoking initiation compared with those without any impairments.
  • Citation: Adebisi, Y. A., & Alshahrani, N. Z. (2026). Functional disability and the risk of subsequent smoking initiation: A prospective cohort analysis. Addictive Behaviors, 175, 108588. https://doi.org/10.1016/j.addbeh.2025.108588
    • Acknowledgments: This research was conducted independently without funding from any specific grant or organization. The open access publication fee was covered by the University of Glasgow through their agreement with Elsevier. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

PREVALENCE

2025: Article Cigarette Smoking among Adults with Disabilities

• Current cigarette smoking is significantly higher among adults with a disability (27.8%) compared to adults without a disability (13.4%). The percentage of adults with disabilities using E-cigarettes is also higher (8%) compared to adults without disabilities (3.9%).
  • CDC

2022: Trends in Cigarette Smoking Prevalence and Status among U.S. Adults with Disabilities, 2015–2019

• The prevalence of cigarette smoking among people with any disability is decreasing over time but remains higher than those without. People with any disability have similar odds of former smoking and differences exist by disability domain. Future research should explore additional smoking and quit behaviors by disability functioning domain.
  • Schulz JA, Parker MA, Villanti AC. Trends in cigarette smoking prevalence and status among U.S. adults with disabilities, 2015-2019. Drug Alcohol Depend. 2023 Feb 1;243:109738. doi: 10.1016/j.drugalcdep.2022.109738. Epub 2022 Dec 15. PMID: 36535098; PMCID: PMC9930180.
    • We would like to acknowledge Erik S. Parker, PhD for contributions to the analysis in this study. Effort of the authors was provided by the National Institute on Drug Abuse of the National Institutes of Health under Award Number U54DA036114 (JAS) and U54CA229973 (ACV). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

SMOKING CESSATION

2019: Evidence for the Fidelity and Effectiveness of Living Independent From Tobacco for People with Disabilities and Their Caregivers

• People with disabilities (PWD) are more likely to use tobacco and less likely to access tobacco cessation programs compared with people without disabilities. Living Independent From Tobacco (LIFT), an evidence-based intervention designed for PWD, was piloted with dyads of PWD (n = 5) and their caregivers (n = 7). As an important source of practical and social support for PWD, caregivers also impact health-related attitudes, knowledge, and behaviors of PWD. Caregivers who smoke may unwittingly interfere with cessation efforts of the people they support. We found that LIFT could be offered to dyads of PWD and their caregivers with fidelity.
• Although participants in this study did not quit tobacco altogether, they reduced tobacco use by 50% at 6-months, the equivalent of 10 fewer cigarettes per day. This finding is significant for several reasons. Reducing tobacco use is associated with a parallel reduction in smoking-related health risk.
  • Havercamp SM, Barnhart WR, Ellsworth D, Coleman E, Lorenz A, Whalen Smith CN, Riddle IK. Evidence for the Fidelity and Effectiveness of Living Independent From Tobacco for People with Disabilities and Their Caregivers. Tob Use Insights. 2019 Jan 23;12:1179173X18825075. doi: 10.1177/1179173X18825075. PMID: 30718966; PMCID: PMC6348572.
    • This project was supported by the Ohio Department of Health Cooperative Agreement No. RFP CSSP904017.

2013: A fresh look at tobacco harm reduction: the case for the electronic cigarette

• Smokers of any age can reap substantial health benefits by quitting. In fact, no other single public health effort is likely to achieve a benefit comparable to large-scale smoking cessation.
• E-cigs might be the most promising product for tobacco harm reduction to date, because, besides delivering nicotine vapour without the combustion products that are responsible for nearly all of smoking’s damaging effect, they also replace some of the rituals associated with smoking behaviour.
• Nicotine’s beneficial effects include correcting problems with concentration, attention and memory, as well as improving symptoms of mood impairments. Keeping such disabilities at bay right now can be much stronger motivation to continue using nicotine than any threats of diseases that may strike
• Nicotine’s beneficial effects can be controlled, and the detrimental effects of the smoky delivery system can be attenuated, by providing the drug via less hazardous delivery systems. Although more research is needed, e-cigs appear to be effective cigarette substitutes for inveterate smokers, and the health improvements enjoyed by switchers do not differ from those enjoyed by tobacco/nicotine abstainers.
• PDF Version
  • Citation: Polosa R, Rodu B, Caponnetto P, Maglia M, Raciti C. A fresh look at tobacco harm reduction: the case for the electronic cigarette. Harm Reduct J. 2013 Oct 4;10:19. doi: 10.1186/1477-7517-10-19. PMID: 24090432; PMCID: PMC3850892.
    • Acknowledgments: R.P. is Professor of Medicine and he is supported by the University of Catania, Italy. He has received lecture fees and research funding from GlaxoSmithKline and Pfizer, manufacturers of stop smoking mediactions. He has also served as a consultant for Pfizer and Arbi Group Srl (Milano, Italy), the distributor of Categoria™ e-Cigarettes. R.P.’s research on electronic cigarettes is currently supported by LIAF (Lega Italiana AntiFumo). B.R.’s research is supported by unrestricted grants from tobacco manufacturers to the University of Louisville, and by the Kentucky Research Challenge Trust Fund. P.C. and C.R. are Assistant Professors and they are supported by the University of Catania, Italy. M.M is researcher and she is supported by the University of Catania, Italy. They have no relevant conflict of interest to declare in relation to this work.

INCLUSION

2024: Article Improving tobacco use research, treatments for people with disabilities

• Regnier points out that the health equity problem at hand is not simply a shortage of tailored treatment options — there’s also a dearth of research on smoking among people with IDD. He recently conducted a literature review that found only two published papers on the topic of smoking cessation treatment for this population in the U.S. In an effort to address this gap in knowledge, he’s now working as a post-doctoral fellow in the University of Kentucky College of Medicine’s Pharmacology of Addiction Lab (PAL), aiming to improve how smoking is assessed, measured and treated among people with IDD.
  • University of Kentucky
    • Since coming to UK, Regnier has received a pilot grant from the Department of Behavioral Science in the UK College of Medicine, an Early Career Investigator Award from the College on Problems of Drug Dependence (CPDD) and a travel award from CPDD as well.

2022: Creating a Tobacco Cessation Program for People with Disabilities: A Community Based Participatory Research Approach

• The purpose of this study was to develop a tobacco cessation program designed by and for people with disabilities (PWD)...Community-Based Participatory Research (CBPR) was conducted to develop a tobacco cessation group treatment program for PWD.
  • Pomeranz JL, Moorhouse MD, King J, Barnett TE, Young ME, Simmons V, Brandon T, Stetten N. Creating a Tobacco Cessation Program for People with Disabilities: A Community Based Participatory Research Approach. J Addict Res Ther. 2014;5(4):1000204. doi: 10.4172/2155-6105.1000204. Epub 2014 Dec 21. PMID: 35492032; PMCID: PMC9053313.
    • This work was supported by the National Institute of Health (5R21CA141600-2).

EXCLUSION

2023: Inequity in smoking cessation clinical trials testing pharmacotherapies: exclusion of smokers with mental health disorders

• We included 279 RCTs from 13 Cochrane reviews. Of all studies, 51 (18.3%) explicitly excluded participants with any MHDs, 152 (54.5%) conditionally excluded based on certain MHD criteria and 76 (27.2%) provided insufficient information to ascertain either inclusion or exclusion. Studies of antidepressant medications used for smoking cessation were found to be 3.33 times more likely (95% CI 1.38 to 8.01, p=0.007) to conditionally exclude smokers with MHDs than explicitly exclude compared with studies of nicotine replacement therapy.
  • Talukder SR, Lappin JM, Boland V, McRobbie H, Courtney RJ. Inequity in smoking cessation clinical trials testing pharmacotherapies: exclusion of smokers with mental health disorders. Tob Control. 2023 Jul;32(4):489-496. doi: 10.1136/tobaccocontrol-2021-056843. Epub 2021 Dec 3. PMID: 34862325; PMCID: PMC10314072.
    • The National Drug and Alcohol Research Centre at the University of New South Wales (UNSW), Australia, is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund and by infrastructure support from the UNSW, Australia. SRT is supported by a National Drug and Alcohol Research Centre PhD scholarship. RJC is supported by a National Health and Medical Research Council Career Development Fellowship. HM has received honoraria for speaking at smoking cessation meetings and attending advisory board meetings that have been organised by Pfizer.

2019: Reasons for Exclusion from a Smoking Cessation Trial: An Analysis by Race/Ethnicity

• Study ineligibility, and reasons for exclusion (contraindications for nicotine patch use, serious mental illness [SMI, eg, bipolar disorder or schizophrenia], alcohol dependence or illicit drug use, current tobacco treatment, attendance barriers [eg, transportation], and other concerns [eg, aggressive, intoxicated, disruptive, visibly ill]).
• Of 1,206 individuals screened, 36% were ineligible. The most frequent reasons were SMI (28%), alcohol dependence or drug use (10%), and attendance barriers (7%). Ineligibility was greater among African Americans (42%) and Hispanics (37%), compared with Whites (24%; P<.001). Compared with African Americans and Hispanics, Whites were more likely to be excluded for single reasons, including attendance barriers, and medical conditions (P<.05). African Americans were more than twice as likely as Whites to be excluded for 3 or more reasons (12% vs 5% respectively, P<.05).
  • Webb Hooper M, Asfar T, Unrod M, Dorsey A, Correa JB, Brandon KO, Simmons VN, Antoni MA, Koru-Sengul T, Lee DJ, Brandon TH. Reasons for Exclusion from a Smoking Cessation Trial: An Analysis by Race/Ethnicity. Ethn Dis. 2019 Jan 17;29(1):23-30. doi: 10.18865/ed.29.1.23. PMID: 30713413; PMCID: PMC6343546.
    • We gratefully acknowledge the Florida Department of Health, James and Esther King Biomedical Research Program (5JK01), the Sylvester Comprehensive Cancer Center, and the Moffitt Cancer Center for funding this study. We also thank Quitville research staff for their contributions to the study.

STIGMA

2019: ES13.05 Stigma and Impact of Tobacco Control Policy

• The stigma reduces the funding available for lung cancer research. In the US, federal funding for lung cancer research per lung cancer death is only 15% of the funding amount for breast cancer per breast cancer death.
• In a Global Lung Cancer Coalition survey, one in five people (21%) agreed with the statement that they have less sympathy for people with lung cancer than for people with other types of cancer.
• Stigmatization of smokers has the greatest impact on the socioeconomically deprived, the disadvantaged populations. These populations have the highest prevalence of smokers and encounter the stigma of their race or disadvantage (poverty, disability, sexual preference, behavioral health etc.) in addition to the stigma associated with smoking.
• This stigmatization leads people who smoke to be less likely to seek medical care when they have symptoms, more likely to lie about their smoking, more likely to be refused access to care including curative surgery for early stage lung cancer unless they quit smoking, less likely to be offered smoking cessation help if they are uncomfortable disclosing their smoking status due to stigma and bias from their healthcare professional.
  • Citation: Borondy Kitts, A. (2019). ES13.05 stigma and impact of tobacco control policy [Conference abstract]. Journal of Thoracic Oncology, 14(10 Suppl.), S48–S49. https://doi.org/10.1016/j.jtho.2019.08.130