Tobacco and the institutionalized mentally retarded: usage choices and ethical considerations.

Patterns of tobacco use were observed among 749 people diagnosed with mental retardation residing in a state-operated facility. Specifically, individual preference for tobacco products and frequency of use were documented. Subjects were observed using several types of tobacco products: cigarettes, cigars, chewing tobacco, snuff, and cigarette butts. Approximately 7% (n = 52) used at least one form of tobacco; ten individuals used more than one tobacco product. Interestingly, 20.5% of the individuals diagnosed with mild or moderate mental retardation (n = 122) consumed tobacco products, a pattern of behavior that closely approximates that of the general population (20-24%). Ethical considerations pertaining to the availability of tobacco products to this special population are presented.