+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Tobacco and alcohol-related interventions for people with mild/moderate intellectual disabilities: a systematic review of the literature



Tobacco and alcohol-related interventions for people with mild/moderate intellectual disabilities: a systematic review of the literature



Journal of Intellectual Disability Research 57(5): 393-408



The behavioural determinants of health among people with mild/moderate intellectual disabilities (ID) are of increasing concern. With the closure of long-stay institutions, more people with ID are living in the community. As they lead more ordinary and less restricted lives, people with ID may be exposed to social and environmental pressures that encourage them to adopt behaviours that impact negatively on their health. Levels of smoking and alcohol consumption in this client group are of particular concern. We undertook a mixed method review of the literature, aiming to assess the Feasibility, Appropriateness, Meaningfulness and Effectiveness (FAME) of interventions designed to address the use of tobacco and/or alcohol in people with mild/moderate ID. Key electronic databases were searched (e.g., Medline, Cochrane Register of Controlled Trials, PsycINFO) from 1996 to 2011. The search was developed using appropriate subject headings and key words (e.g., intellectual disability, tobacco use, alcohol drinking, health promotion). On completion of the database searches, inclusion/exclusion criteria, based on an adaptation of the PICO framework (Population, Intervention, Comparison, Outcomes), were applied. Methodological quality was assessed using a seven-point rating scale. Database searches identified 501 unique records, of which nine satisfied the inclusion criteria. Four focused on tobacco, three on alcohol and two on both tobacco and alcohol. Located in the U.K., the U.S.A. and Australia, the studies aimed to increase knowledge levels and/or change behaviour (e.g., to encourage smoking cessation). One was a randomised controlled trial, one a quasi-experiment and the others were before and after studies and/or case studies. Methodological quality was poor or moderate. The combined studies had a sample size of 341, with ages ranging from 14 to 54 years. The interventions were delivered by professionals (e.g., in health, social care, education) during sessions that spanned a period of three weeks to one academic year. The studies highlighted a number of important issues linked to the appropriateness of interventions for this client group (e.g., use of pictures, quizzes, role play, incentives); however, in the majority of cases the interventions appeared to lack a theoretical framework (e.g., behaviour change theory). The appropriateness of the outcome measures for use with this client group was not tested. One study discussed feasibility (teachers delivering lessons on alcohol and tobacco) and only one was informative in terms of effectiveness, i.e., increasing knowledge of the health and social dangers of smoking and excessive alcohol consumption. This review is the first to systematically collate evidence on tobacco and alcohol-related interventions for people with ID. While there is currently little evidence to guide practice, the review delivers clear insights for the development of interventions and presents a strong case for more robust research methods. In particular there is a need to test the effectiveness of interventions in large-scale, well-designed trials and to ensure that outcome measures are developed/tailored appropriately for this client group.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 056597649

Download citation: RISBibTeXText

PMID: 22458301

DOI: 10.1111/j.1365-2788.2012.01543.x


Related references

Tobacco and Alcohol Use in People With Mild/Moderate Intellectual Disabilities: Giving Voice to Their Health Promotion Needs. Journal of Applied Research in Intellectual Disabilities 30(4): 612-626, 2017

Effectiveness of interventions for adults with mild to moderate intellectual disabilities and mental health problems: systematic review and meta-analysis. British Journal of Psychiatry 209(6): 469-474, 2016

Interventions for adults with mild intellectual disabilities and mental ill-health: a systematic review. Journal of Intellectual Disability Research 60(6): 615-622, 2016

Extended brief intervention to address alcohol misuse in people with mild to moderate intellectual disabilities living in the community (EBI-ID): study protocol for a randomised controlled trial. Trials 16: 114, 2015

Diabetes in people with intellectual disabilities: A systematic review of the literature. Research in Developmental Disabilities 47: 352-374, 2015

The effectiveness of psychosocial interventions for children with a psychiatric disorder and mild intellectual disability to borderline intellectual functioning: A systematic literature review and meta-analysis. Clinical Child Psychology and Psychiatry 21(1): 156-171, 2016

The Effectiveness of Rehabilitation Interventions on the Employment and Functioning of People with Intellectual Disabilities: A Systematic Review. Journal of Occupational Rehabilitation 29(4): 773-802, 2019

A systematic review on the effect of exercise interventions on challenging behavior for people with intellectual disabilities. Research in Developmental Disabilities 35(7): 1507-1517, 2014

Improving procedural fidelity of behavioural interventions for people with intellectual and developmental disabilities: A systematic review. Journal of Applied Research in Intellectual Disabilities 32(4): 762-778, 2019

Psychological interventions for women with intellectual disabilities and forensic care needs: a systematic review of the literature. Journal of Intellectual Disability Research 59(4): 319-331, 2015

Pharmacists' medicines-related interventions for people with intellectual disabilities: a narrative review. International Journal of Clinical Pharmacy 37(4): 566-578, 2015

Medical Certificates of Cause of Death for people with intellectual disabilities: A systematic literature review. Journal of Applied Research in Intellectual Disabilities 31(5): 659-668, 2018

Exercise interventions to improve balance for young people with intellectual disabilities: a systematic review and meta-analysis. Developmental Medicine and Child Neurology 61(4): 406-418, 2019

Could participant-produced photography augment therapeutic interventions for people with intellectual disabilities? A systematic review of the available evidence. Journal of Intellectual Disabilities 22(1): 74-95, 2018

The efficacy of interventions designed to prevent and protect people with intellectual disabilities from sexual abuse: a review of the literature. Journal of Adult Protection 7(2): 13-27, 2005