Tobacco and alcohol use in people with mild/moderate intellectual disabilities: giving voice to their health promotion needs

Susan Kerr, Margaret Lawrence, Alan R. Middleton, Lorna Fitzsimmons, Chris Darbyshire

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Background Concerns have been raised about the use/misuse of tobacco and alcohol by people with mild-moderate intellectual disabilities. Aiming to address an identified gap in the current evidence base, the current study sought to gain an understanding of the tobacco and alcohol-related health promotion needs of this client group.

Methods Informed by the principles of social cognitive theory, data were collected using focus group and telephone interviews. Participants were 16 people with intellectual disabilities, two family carers and 15 health and social care professionals. Data were analysed using the Framework approach.

Findings Four themes were described: Being like others; Social and emotional influences; Understandings, mis-understandings and learning from experience; and, Choices and challenges. Reasons for smoking and drinking alcohol echoed those of the general population; however, health promotion needs were more complex (e.g. linked to problems with consequential thinking; low levels of self-efficacy).

Conclusion This paper provides insight into the tobacco and alcohol-related health promotion needs of people with intellectual disabilities. There is a need for integrated service provision that addresses both personal and environmental influences on behaviour.
Original languageEnglish
Pages (from-to)612-626
Number of pages15
JournalJournal of Applied Research in Intellectual Disabilities
Issue number4
Early online date21 Mar 2016
Publication statusPublished - Jul 2017



  • alcohol
  • health promotion
  • intellectual disability
  • qualitative research
  • social cognitive theory
  • tobacco

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