Factors influencing engagement in smoking cessation for adults with Intellectual and Developmental Disabilities

INTRODUCTION: People with Intellectual and Developmental Disabilities (IDD) may experience tobacco use patterns that place them at elevated risk for nicotine dependence. However, there are few available interventions tailored for people with IDD, suggesting people with IDD may rely on approaches developed for people without disabilities. The purpose of this study was to identify factors influencing engagement in tobacco treatment among adults with IDD. METHODS: Semi-structured interviews with key stakeholders (n = 39) were conducted, including adults with IDD who currently smoked cigarettes (n = 10), adults with IDD that had quit or reduced smoking (n = 9), disability service providers (n = 12), and tobacco treatment providers (n = 8). Codes were categorized based as individual, social, and structural factors influencing engagement in treatment. A hybrid inductive/deductive coding process was used: deductively structured using the Practical, Robust Implementation and Sustainability Model framework and inductively coded by the first two authors using participant responses. RESULTS: On the individual level, smoking to cope with stress and manage withdrawal were commonly reported by participants with IDD, while concerns over difficulties with comprehension of treatment components were reported by providers. Exposure to peer and provider cigarette smoking was a common social-level barrier reported by all participant groups. On the structural level, financial and transportation barriers were most commonly reported. CONCLUSIONS: Understanding factors that impact smoking cessation treatment engagement can guide intervention development for adults with IDD. Person centered treatments should include coping-skills training, withdrawal management, and be developed including accessible, tailored materials. Future studies should evaluate these methods among people with IDD.