Consommation de tabac et vapotage chez les personnes en situation de handicap intellectuel : une enquête dans les Hauts-de-France

Introduction – Among people with intellectual disabilities, the prevalence of smoking and vaping, the types of products consumed, the methods of obtaining them and the impact of smoking prevention campaigns have not been documented by any epidemiological survey in France to date. Methods – The Santé publique France Health Barometer survey translated its smoking and vaping items into Easy Read format in a version called "The Health Thermometer". This was administered to over 1,000 people with intellectual disabilities in the Hauts-de-France region between September 2022 and April 2023. Results – In the Hauts-de-France region, 23.5% of people with intellectual disabilities declared smoking and 19.6% on a daily basis, more often men than women (22.9% vs 14.5%, p=0.001). A further 8.6% vaped and 4.9% daily. The vast majority of smokers consumed manufactured cigarettes or tobacco for hand rolling or tubing. The average number of cigarettes smoked daily was 12.4, with men smoking more than women (13.6 vs 9.5, p=0.009). A significant proportion of smokers (36%) declared buying their tobacco abroad (in Belgium). Although 45% of smokers were aware of "No Smoking Month", almost none had signed up to take part. Conclusion – People with intellectual disabilities are users of tobacco products who, like the general population, adopt opportunistic strategies to circumvent the public policies of price rises. They do not seem receptive to prevention campaigns aimed at the general population. They are also less likely to use harm reduction tools for smoking. These results argue for greater inclusiveness in smoking prevention campaigns, greater intelligibility of the messages and tools made available and, above all, the implementation of complex interventions promoting empowerment and a health-friendly environment based on co-construction and participatory research.