Associations between disability and tobacco use in 31 low-income and middle-income countries: a secondary analysis of cross-sectional data from Multiple Indicator Cluster Surveys

Background: Globally, individuals with disabilities may experience disproportionate tobacco use burden, though evidence comes predominantly from high-income settings. A substantial knowledge gap persists regarding tobacco consumption patterns among populations with disability in low- and middle-income countries (LMICs). This study aimed to examine associations between disability and tobacco use across diverse LMIC contexts. Methods: We conducted secondary analysis of cross-sectional data from the sixth round of UNICEF-supported Multiple Indicator Cluster Surveys (MICS), spanning 2017-2023 across 31 LMICs. Participants were adults aged 18-49 years in the MICS Adult Functioning module with valid survey weights (weight >0); we excluded respondents with non-positive weights. For pooled meta-analyses, we applied a prespecified minimum sample-size criterion (