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Grant Details

Grant Number: 5R01CA137616-06 Interpret this number
Primary Investigator: Dunsiger, Shira
Organization: Miriam Hospital
Project Title: Motivating Smokers with Mobility Impairments to Quit Smoking
Fiscal Year: 2014


Abstract People with physical disabilities experience similar health disparities as other disadvantaged groups (e.g., no insurance, decreased access to medical and preventive care, more co-morbidities) but significantly less attention is paid to their health promotion. While smoking cessation interventions have been developed for other disadvantaged groups, none exist for people with physical disabilities. People with physical disabilities (mobility impairments) who use assistance to ambulate have higher smoking rates (32.5%) than people who have a disability and do not need assistance (23%) and people who are not disabled (19.8%; Brawarsky et al. 2002). The aims of the current study are to: 1) develop a series of theory-based intervention DVDs focused on motivating smoking cessation among people with mobility impairments (i.e., chronically use some type of assistance to walk such as walker, cane, wheelchair, braces, etc) and 2) test the efficacy of the Intervention DVDs vs. Print-based Standard Care among 560 smokers with mobility impairments in a randomized trial. The materials in both groups will be mailed on a monthly basis for four months, and are organized in separate sections according to readiness to quit. Participants in both groups will receive a) nicotine patches at no cost if they are ready to quit and b) brief phone calls (~5 minutes) between mailings to assess and encourage viewing the materials. We hypothesize that smokers who are randomized to receive the Intervention DVDs will be significantly more likely to achieve 7-day and 30-day point-prevalence abstinence at 1, 6, and 12- month follow-ups vs. those who receive Print-based Standard Care. The Intervention DVDs will be based on Behavioral Activation Theory, and address specific barriers to quitting in this population (increased stress, decreased positive affect, increased depressed mood, activity restriction, and self-efficacy). We hypothesize that the intervention will impact these mediators directly, as well as indirectly through Behavioral Activation (goal setting and pleasant events). Our series of preliminary studies support the use of these mediators for people with mobility impairments and the use of DVDs as an acceptable mode of intervention, given the economic and mobility limitations of this population. If effective, our DVD intervention could have a high level of public health and clinical significance, as it could be easily disseminated at low cost through national disability-related organizations, networks of independent living centers, or physician offices, and substantially improve the health and quality of life for people with physical disabilities. This study is innovative because no studies have targeted this population, it applies Behavioral Activation Theory to smoking cessation, and it examines relatively novel mediators in the field of smoking (e.g., positive affect, behavioral activation).


Greater engagement in valued activities is associated with less barriers to quitting smoking among smokers with mobility impairments.
Authors: Borrelli B. , Endrighi R. , Dunsiger S. , Busch A.M. , Bock B.C. , Risica P.M. , Hughes R.B. , Lasater T. .
Source: Disability and health journal, 2023 Oct; 16(4), p. 101480.
EPub date: 2023-05-02.
PMID: 37236878
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Associations Between Smoking Status and Physical and Mental Health-Related Quality of Life Among Individuals With Mobility Impairments.
Authors: Endrighi R. , Zhao Y. , Hughes R.B. , Kumar D. , Borrelli B. .
Source: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2022-08-30; 56(9), p. 890-899.
PMID: 34453512
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Perceived Pain and Smoking Interrelations and Expectancies Are Associated With Pain and Smoking Cessation in Individuals With Mobility Impairments.
Authors: Endrighi R. , Rueras N. , Dunsiger S.I. , Borrelli B. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2021-01-07; 23(1), p. 179-185.
PMID: 31287549
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Cigarette smoking among adults with mobility impairments: a US population-based survey.
Authors: Borrelli B. , Busch A. , Dunsiger S. .
Source: American journal of public health, 2014 Oct; 104(10), p. 1943-9.
EPub date: 2014-04-17.
PMID: 25208005
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Methods used to quit smoking by people with physical disabilities.
Authors: Borrelli B. , Busch A.M. , Trotter D.R. .
Source: Rehabilitation psychology, 2013 May; 58(2), p. 117-23.
EPub date: 2013-02-25.
PMID: 23437992
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Integrating asthma education and smoking cessation for parents: financial return on investment.
Authors: McQuaid E.L. , Garro A. , Seifer R. , Hammond S.K. , Borrelli B. .
Source: Pediatric pulmonology, 2012 Oct; 47(10), p. 950-5.
EPub date: 2012-03-29.
PMID: 22467563
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The Relationship between Smoking and Depression Post-Acute Coronary Syndrome.
Authors: Busch A.M. , Borrelli B. , Leventhal A.M. .
Source: Current cardiovascular risk reports, 2012-02-01; 5(6), p. 510-518.
PMID: 22384285
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Valued life activities and readiness to quit smoking among mobility-impaired smokers.
Authors: Busch A.M. , Borrelli B. .
Source: Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 2012 Jan; 31(1), p. 122-5.
EPub date: 2011-08-29.
PMID: 21875204
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Utilizing reliable and clinically significant change criteria to assess for the development of depression during smoking cessation treatment: the importance of tracking idiographic change.
Authors: Busch A.M. , Wagener T.L. , Gregor K.L. , Ring K.T. , Borrelli B. .
Source: Addictive behaviors, 2011 Dec; 36(12), p. 1228-32.
EPub date: 2011-07-30.
PMID: 21872401
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Risk perception and smoking behavior in medically ill smokers: a prospective study.
Authors: Borrelli B. , Hayes R.B. , Dunsiger S. , Fava J.L. .
Source: Addiction (Abingdon, England), 2010 Jun; 105(6), p. 1100-8.
EPub date: 2010-03-22.
PMID: 20331572
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Is provider training effective? Changes in attitudes towards smoking cessation counseling and counseling behaviors of home health care nurses.
Authors: Borrelli B. , Lee C. , Novak S. .
Source: Preventive medicine, 2008 Apr; 46(4), p. 358-63.
EPub date: 2007-09-11.
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