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Health Behaviors--Smoking

Younger women with disabilities are significantly more likely to smoke than non-disabled women in the same age group.

A national survey conducted by the Center for Research on Women with Disabilities in 1997 found higher rates of smoking among women with a variety of disabilities than typical in the general population, with 32 percent of women with disabilities smoking compared to 23 percent of adults in general. An analysis of the National Health Interview Study revealed that smoking among young women with disabilities is nearly double the rate of smoking among young women in the general population.

Distressingly, data from the National Health Interview Survey indicate that women with major lower extremity mobility limitations were less likely to be asked about smoking behavior by their physicians.

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There have been no studies conducted on the consequences of smoking in women with mobility impairments.

In the general population, cigarette smoking is associated with numerous serious health problems, including cardiopulmonary disease, cancers, heart disease, cerebrovascular disease, peptic ulcer disease, peripheral vascular disease, and infertility, as well as a variety of irreversible health effects on the respiratory system, heart and circulatory system, eyes, digestive system, skin, and other organs.

While smoking is a substantial risk factor for disease and death for anyone, it may impart even higher risks for people with disabilities. For example, research has revealed that smoking is associated with:

  1. increased risk of, and delayed healing of, pressure sores;
  2. length of time it takes for a wound to heal;
  3. poor post-operative outcome in spinal surgeries and joint replacement procedures.

Many persons with mobility limitations and certain disability types have reduced circulatory functioning, and they are prone to increased healing time. It is possible that, given these findings, a person with such a disability who smokes would compound this problem further.

Furthermore, smoking is associated with osteoporosis in women in the general population. As women with mobility impairments already have higher rates of osteoporosis, it is possible that smoking would place a woman with a disability at even greater risk for fractures and further limitations in functioning.

Although there have been no studies conducted on the consequences of smoking in women with disabilities, some researchers have investigated the consequences of smoking in people with specific conditions. For example, cigarette smoking appears to play an important role in the progression and severity of rheumatoid arthritis. In persons with cutaneous lupus erythematosus, smoking may cause patients to be less responsive to standard treatments. Some researchers report that pulmonary function was significantly lower in smokers with spinal cord injury. In people who have multiple sclerosis, cigarette smoking may negatively impact the central nervous system and produce a temporary weakening of motor functioning. Additionally, for below-knee amputees with vascular etiology, smoking decreases walking distance and the ability to walk outdoors, and increases walking time.

Furthermore, some evidence suggests that cigarette smoking plays a role in the development of rheumatoid arthritis and multiple sclerosis, and increases one's risk for limb amputation.

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There have been no studies conducted on how best to help women with disabilities to stop smoking.

There are few health promotion programs devoted to smoking cessation for people with disabilities. Given the high rates of smoking among women with disabilities and the increased risk for secondary conditions, smoking cessation efforts for this population should be given higher priority. Future research should attempt to identify smoking cessation strategies best suited to women with disabilities, who may have significant transportation or cost barriers. Smoking cessation programs available to the general population should conduct outreach to women with disabilities and work to raise the awareness of additional adverse health effects for this population. Researchers should also consider developing programs specifically for women with disabilities.

Additionally, physicians should become more aware of the heightened risks associated with smoking for women with disabilities and regularly discuss smoking behaviors with disabled patients. As data from the National Health Interview Survey indicates, women with major lower extremity mobility limitations were less likely to be asked about smoking behavior by their physicians. Arguably, physicians should be concentrating their smoking cessation efforts towards this very group.

Further research is also needed to clarify the relationship between smoking and the aforementioned secondary conditions.

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Here's what you can do

Many organizations offer information about smoking and women's health plus strategy advice you can use when you're ready to stop. While none of these specifically addresses the situation of women with disabilities, much of the information is applicable to all women.

Smoking and How to Quit, U.S. Dept. of Health and Human Services

Calculate your health risk from smoking

You can quit smoking now! 877-448-7848

Office on Smoking and Health, Centers for Disease Control and Prevention 770-488-5705 or 800-CDC-1311

Wanting to Exhale: African American Women & Smoking, Black Women's Health Imperative

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