title: Risk behaviors related to cigarette smoking among persons with spinal cord injury.
abstract: BACKGROUND
  Smoking, while detrimental to health in any population, has greater health implications for those with spinal cord injury (SCI) because of additional risks posed by SCI. The aims of this study were to document smoking status after SCI and to assess relationships between smoking status with injury severity and alcohol/pain medication use.
  
  
  METHODS
  Participants (n = 1,076) were identified from a large rehabilitation hospital in the southeastern part of the United States. Eligibility criteria included (a) traumatic SCI resulting in residual impairment, (b) adult, and (c) 1+ years postinjury. Previous and current cigarette smoking and quitting attempts were assessed. Relationships were assessed between smoking status (current, former, and never), alcohol use, and pain medication use.
  
  
  RESULTS
  Of participants (72% male, M age = 49.6 years, M = 16.1 years since SCI), 49.2% had never smoked, 28.2% were former smokers, and 22.6% were current smokers. Of current smokers, 39.2% attempted quitting in the past year and 77.2% had ever tried to quit. Only 29.9% of those who ever tried to quit sought professional help. Ambulatory persons, regardless of injury level, were 2.32 times more likely to be current smokers than nonambulatory persons with a high-level cervical injury. Lower socioeconomic status, binge drinking, and misuse of pain medication all predicted current smoking.
  
  
  CONCLUSIONS
  Smoking prevalence among persons with SCI is largely consistent with the general population. Additionally, we found smoking to be associated with other risk behaviors (binge drinking and prescription medication misuse) and differs by injury severity. Future studies should assess smoking interventions, which may differ by injury severity.
authors.affiliation: Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC;
authors.forename: Lee L
authors.initials: LL
authors.lastname: Saunders
authors.forename: James S
authors.initials: JS
authors.lastname: Krause
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carpenter
authors.forename: Michael
authors.initials: M
authors.lastname: Saladin
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D040343:Behavioral Risk Factor Surveillance System; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods; D015144:Southeastern United States / Q000453:epidemiology; D013119:Spinal Cord Injuries / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires