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Disparities in Tobacco Use by Disability and Type: Findings From the 2019 National Health Interview Survey

  • Jonathan A. Schulz
    Correspondence
    Address correspondence to: Jonathan A. Schulz, PhD, MPH, Vermont Center on Behavior and Health, Larner College of Medicine, The University of Vermont, 1 South Prospect, Burlington VT 05401.
    Affiliations
    Vermont Center on Behavior and Health, Larner College of Medicine, The University of Vermont, Burlington, Vermont
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  • Julia C. West
    Affiliations
    Vermont Center on Behavior and Health, Larner College of Medicine, The University of Vermont, Burlington, Vermont

    Department of Psychological Science, The University of Vermont, Burlington, Vermont
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  • Jean P. Hall
    Affiliations
    Institute for Health and Disability Policy Studies, The University of Kansas, Lawrence, Kansas
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  • Andrea C. Villanti
    Affiliations
    Vermont Center on Behavior and Health, Larner College of Medicine, The University of Vermont, Burlington, Vermont

    Department of Psychological Science, The University of Vermont, Burlington, Vermont

    Rutgers Center for Tobacco Studies, New Brunswick, New Jersey
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      Introduction

      People with disabilities report a higher prevalence of cigarette use than people without disabilities. However, evidence is limited on the relationships between disability type, degree of functional difficulty, and other tobacco product use.

      Methods

      Data from the 2019 U.S. National Health Interview Survey were used to estimate the prevalence and odds of tobacco product use for 6 disability types and degree of functional difficulty. Bivariate and multivariable analyses conducted in 2021 examined the associations between tobacco product use and disability type.

      Results

      Compared to adults who reported no difficulty, current cigarette use prevalence was higher for adults who reported a lot of difficulty/cannot do at all to vision (21.5% vs 13.1%), hearing (19.6% vs 13.6%), mobility (20.0% vs 12.9%), and cognitive (25.4% vs 12.9%) disability questions. The odds of current cigarette (AOR=1.32), pipe (AOR=1.85), and smokeless tobacco (AOR=1.57) use were significantly higher for adults who reported a lot of difficulty/cannot do at all to any disability question and significantly higher for current cigarette (AOR=1.24), e-cigarette (AOR=1.33), pipe (AOR=1.45), and smokeless tobacco (AOR=1.29) use for adults who reported some difficulty to any disability question than those who reported no difficulty. Pipe use was correlated with mobility difficulty (AOR=1.68), and smokeless tobacco use was correlated with hearing difficulty (AOR=1.95).

      Conclusions

      People who reported difficulty with vision, hearing, mobility, or cognition had a higher cigarette use prevalence than people without disabilities. Other tobacco use differed by disability type. Future research should tailor tobacco interventions to reduce these disparities.
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