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. 2024 Nov-Dec;139(6):724-733.
doi: 10.1177/00333549241249339. Epub 2024 May 23.

Disparities in Smoking and Heavy Drinking Behaviors by Disability Status and Age of Disability Onset: Secondary Analysis of National Health Interview Survey Data

Cristina A Sarmiento  1   2 , Anna Furniss  3 , Megan A Morris  3   4 , Michelle L Stransky  5 , Darcy A Thompson  3   6
Affiliations

Disparities in Smoking and Heavy Drinking Behaviors by Disability Status and Age of Disability Onset: Secondary Analysis of National Health Interview Survey Data

Cristina A Sarmiento et al. Public Health Rep. 2024 Nov-Dec.

Abstract

Objectives: People with childhood-onset disabilities are living into adulthood, and the prevalence of smoking and illicit drug use among adults with disabilities is high. We evaluated the relationship between disability status and age of disability onset, current cigarette smoking status, and heavy alcohol drinking.

Methods: We conducted a secondary data analysis of the National Health Interview Survey (NHIS), a US survey on illness and disability. Among 2020 NHIS participants aged 22-80 years (n = 28 225), we compared self-reported prevalence of current cigarette smoking and heavy alcohol drinking among those with and without disabilities and among those with childhood- versus adult-onset disabilities. We used adjusted logistic regression analysis to calculate the adjusted odds ratios (AORs) of current smoking and heavy alcohol drinking based on disability status and age of disability onset.

Results: Compared with adults without disabilities, adults with disabilities were significantly more likely to report current smoking (23.5% vs 11.2%; P < .001) and significantly less likely to report heavy alcohol drinking (5.3% vs 7.4%; P = .001). The prevalence of these behaviors did not vary significantly by age of disability onset. In adjusted logistic regression models, adults with disabilities had significantly higher odds of current smoking (AOR = 1.76; 95% CI, 1.53-2.03) and similar odds of heavy alcohol drinking (AOR = 0.82; 95% CI, 0.65-1.04) compared with adults without disabilities. The odds of these health behaviors did not vary significantly by age of disability onset.

Conclusions: Adults with disabilities overall may be at high risk for these unhealthy behaviors, particularly smoking, regardless of age of disability onset. Routine screening and cessation counseling related to smoking and unhealthy alcohol use are important for all people with disabilities.

Keywords: alcohol; developmental disabilities; disability; smoking.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Unadjusted and adjusted odds of current smoking and heavy alcohol drinking among adults with a disability compared with adults without a disability, 2020 National Health Interview Survey, United States. Disability refers to self-reported difficulty walking or climbing stairs, communicating, remembering or concentrating, self-care, or doing errands alone. The reference group is no disability; logistic regression models adjusted for age, sex, relationship status, race and ethnicity, annual household income, and health insurance status. Data source: 2020 National Health Interview Survey.
Figure 2.
Figure 2.
Unadjusted and adjusted odds of current smoking and heavy alcohol drinking among adults with childhood-onset disability compared with adults with adult-onset disability, 2020 National Health Interview Survey, United States. Disability refers to self-reported difficulty walking or climbing stairs, communicating, remembering or concentrating, self-care, or doing errands alone. The reference group is adult-onset disability; logistic regression models adjusted for sex, relationship status, race and ethnicity, annual household income, and health insurance status. Age was colinear with age of onset, so it was not included in regression models. Data source: 2020 National Health Interview Survey.
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