title: Tobacco and Alcohol Use in People With Mild/Moderate Intellectual Disabilities: Giving Voice to Their Health Promotion Needs.
abstract: 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, this 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.
  
  
  RESULTS
  Four themes were described: being like others; social and emotional influences; understandings, misunderstandings 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).
  
  
  CONCLUSIONS
  This article 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.
authors.affiliation: Institute for Applied Health Research/School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Kerr
authors.affiliation: Institute for Applied Health Research/School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Maggie
authors.initials: M
authors.lastname: Lawrence
authors.affiliation: Institute for Applied Health Research/School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Middleton
authors.affiliation: Learning Disability Service, NHS Greater Glasgow & Clyde, Glasgow, UK.
authors.forename: Lorna
authors.initials: L
authors.lastname: Fitzsimmons
authors.affiliation: Institute for Applied Health Research/School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Darbyshire
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D017028:Caregivers / Q000523:psychology; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011582:Psychological Theory; D036301:Qualitative Research; D020377:Self Efficacy; D064424:Tobacco Use / Q000523:psychology*; D055815:Young Adult
keywords: alcohol; health promotion; intellectual disability; qualitative research; social cognitive theory; tobacco