Brief Report
Evaluation of a newly developed tobacco cessation program for people with disabilities

https://doi.org/10.1016/j.dhjo.2015.08.002Get rights and content

Abstract

Background

Tobacco use is the single most preventable cause of morbidity and mortality, accounting for at least 480,000 deaths in the United States annually. People with disabilities smoke at a rate 1.5 times greater than the able-bodied population. Higher incidence of tobacco use among people with disabilities has been directly related to both unique and universal cessation barriers. Despite increased prevalence of tobacco use and cessation obstacles, evidence is lacking on the development of successful interventions targeting people with disabilities.

Objective

We aimed to assess the feasibility, acceptability, and potential effectiveness of a cessation intervention tailored to people with disabilities.

Methods

Eighteen tobacco users with disabilities (56% African American, 64% male) participated in a 4-week, 8-session tobacco cessation program consisting of group sessions on managing addiction, relapse, and lifestyle changes specific to people with disabilities. Semi-structured interviews were conducted at the conclusion of the program. A follow-up measure of smoking status, triggers, and nicotine replacement therapy usage was completed at 4 weeks and 6 months.

Results

Sixteen participants completed the intervention (89%), with participants on average attending 86% of sessions. Most participants rated the program as excellent (83%) or good (8%). Qualitative interviews revealed participants value social support, accessibility, and a tailored program. Four participants (22%) reported abstinence at six months, which is greater than the standard quit rate.

Conclusion

This study suggests tailoring a cessation program to the characteristics unique to people with disabilities may be critical in delivering meaningful and effective cessation interventions among this population.

Section snippets

Methods

This IRB approved study occurred within the context of a larger quasi-experimental study comparing a four-week tobacco cessation intervention designed for people with disabilities (LIFT) to a standard six-week cessation program (Quit Smoking Now). A total of three four-week intervention programs were conducted between September 2012 and December 2013. All program sessions and qualitative interviews were held at a large center for independent living in the southeastern US. Participants were

Results

Sixteen participants completed the intervention (89%), with participants on average attending seven of the eight sessions. Most participants rated the program as excellent (83%) or good (8%). Four participants (22%) reported abstinence at 6 months. Qualitative results centered around three primary groupings: Group characteristics, Program characteristics, and Individual characteristics.

Discussion

Existing studies highlight various components regarding tobacco cessation programs and their effectiveness; however, to our knowledge, no research has looked specifically at cessation for people with disabilities. This study was designed as a process evaluation of a tobacco cessation program designed specifically for people with disabilities. Using qualitative interviews, we were able to gain greater understanding of specific components of the tobacco cessation program that might be more

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  • Cited by (5)

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      State-specific disparities in the prevalence of current e-cigarette use among people with specific type of disability are not fully understood. Studies show that potential factors include influential interactions and exposures (e.g., with caregivers who smoke), permissive tobacco policies in day rehabilitation programs that serve people with disabilities,34,35 limited evidence-based tobacco interventions specifically targeting people with disabilities (e.g., Living Independent From Tobacco),36,37 and low prevalence of tobacco use screening during primary care visits among people with disabilities.38,39 In addition, state-level differences, particularly among younger adults, could potentially be related to state laws prohibiting tobacco sales to persons aged 21 or younger, state laws regarding e-cigarettes in indoor public spaces and taxation of e-cigarettes.40,41

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      In a similar vein, King and colleagues (2016) evaluated the feasibility, acceptability, and potential effectiveness of LIFT in a small sample of tobacco users with disabilities, identifying a high degree of satisfaction with the intervention and preliminary evidence of an association between LIFT and tobacco cessation among PWD (four participants self-reported abstinence from tobacco products 6-months after the intervention). Similar to the findings of Havercamp and colleagues, participants identified social support as an important component underlying success with the LIFT intervention.7 These pilot studies were important and innovative but limited by small sample sizes, which prevented robust statistical analyses.6,7

    The authors have no conflicts of interest to report. Similar research was presented at the 2014 American Public Health Association Conference and recognized at the 2015 Society for Public Health Conference. This project was supported by NIH/NCI Grant #: 5R21CA141600-2.

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