People with mobility impairments may be more likely to smoke than those without mobility impairments, according to a recent study.

Researchers from The Miriam Hospital in Rhode Island found that people with mobility impairments under age 65 have significantly higher rates of smoking and were less likely to attempt quitting than those without mobility impairments. The findings also suggest that and evidence-based, quit-smoking treatments may not be sufficient for this population.

"People with physical disabilities constitute 16.2 percent of the population and the majority of the population will experience physical disability at some point during their lifetime," Belinda Borrelli, lead researcher of the study, said in a statement. "However, the prevalence of smoking among people with disabilities was unknown prior to our paper. Our particular interest was in pinpointing smoking prevalence among those who use a device to help them get around. Literature indicates that those who use mobility aids have higher rates of depression, and in the general population, this is associated with greater smoking rates and lower likelihood of quitting smoking."

For the study, Borelli and her team analyzed more than 13,300 adults between the ages of 21 and 85 years old with mobility impairments such as using special ambulatory equipment and having difficulty walking one-quarter mile without equipment.

Results showed that among 21 to 44 year olds with mobility impairments, 39.2 percent were smokers, compared with only 21.5 percent of adults without mobility impairments. Among 45 to 64 year olds with mobility impairments, 31.2 percent were smokers versus 20.7 percent without mobility impairments.

The analysis also found that women ages 21 to 44 years old with mobility impairments had the highest smoking prevalence at 45.9 percent, exceeding same-aged women without mobility impairments. Men with mobility impairments had greater smoking prevalence than women with mobility impairments. Smokers with mobility impairments were also less likely to attempt quitting than smokers without mobility impairments.

The research team focused on smokers with mobility impairment because in addition to being at risk for the same smoking-related health problems as the general population, this population is at risk for worsening their existing disability and underlying medical condition. Continued smoking exacerbates physical disabilities and causes or contributes to many secondary conditions including respiratory and circulatory difficulties, muscle weakness, delayed wound healing, worsening arthritis and osteoporosis. Smokers with a relapsing-remitting multiple sclerosis (MS) are three times more likely to develop a secondary-progressive disease course.

"It is not clear that evidenced-based treatments that are effective for the general population will be sufficient to help people with mobility impairments quit smoking," Borelli said. "We speculate that smokers with mobility impairments may need more intensive treatment given their greater risk factors for treatment failure such as high depression rates and stress levels, less physical activity and multiple medical comorbidities, coupled with high unemployment and low income."

She added that in the meantime, practitioners should recommend a combination of treatment modalities that include both psychosocial support that can be home based and pharmacological treatment.

The new study was recently published online in advance of print in the American Journal of Public Health.