Multiple tobacco use and increased nicotine dependence among people with disabilities

This study was presented as a poster presentation at the Society for Research on Nicotine and Tobacco Conference in Boston, MA in 2013.

Eric K. Soule, M.P.H., Jamie L. Pomeranz, Ph.D., Michael D. Moorhouse, Ph.D., Tracey E. Barnett, Ph.D.

Department of Behavioral Science and Community Health, College of Public Health and Health Professions, University of Florida, USA



People with disabilities (PWD) are at greatest risk for tobacco use compared to people without disabilities. However, little is known about the use of multiple types of tobacco by PWD.


The purpose of this study was to examine nicotine dependence among a sample of PWD who use multiple types tobacco products. We hypothesized that individuals who used multiple forms of tobacco would have higher levels of nicotine dependence.


A tobacco survey was administered to clients who use tobacco and receive services from an organization that provides independent living services to PWD. The self-report brief survey included measures of nicotine dependence and items indicating the types of tobacco products participants used. A total of 113 male and female participants with disabilities (mean age = 51.7, SD = 10.1) participated in the study.


Multiple tobacco use was reported by 16.8% of the participants and was significantly associated with nicotine dependence. Compared to single tobacco product users, multiple tobacco users were more likely to use tobacco within the first 30 min of waking, believe tobacco the first thing in the morning would be the most difficult to give up, and find it hard to not use tobacco in prohibited locations.


The use of multiple types of tobacco products among PWD disability is relatively common and is associated with greater nicotine dependence. Tobacco cessation interventions targeting PWD should consider the addressing unique challenges of preventing different types of tobacco products.