Prevalence of current smoking and association with meeting 24-h movement guidelines: Results from a national convenience sample of autistic adults.

Laxton et al. (2024) asked 259 autistic adults across the U.S. to fill out an online survey. They wanted to know who smokes and how well those people follow the 24-hour movement guidelines for sleep, exercise, and screen time.

The team used a convenience sample recruited through autism networks and social media. People reported their own smoking status and answered questions about sleep length, sitting time, and moderate-to-vigorous activity.

Current smokers met fewer of the three 24-hour guidelines than non-smokers. The biggest gaps were in sleep and sedentary behavior. Smokers were more likely to sleep too little and to sit for long stretches.

Exercise levels showed a weaker link. In plain words, poor sleep and lots of sitting were the clearest red flags that went hand-in-hand with smoking in this group.

Ballester et al. (2019) already showed that autistic adults sleep worse than typical peers. Paige et al. now add that this poor sleep clusters with smoking, so sleep may be a first place to intervene.

Emerson (2023) found UK teens with and without intellectual disability smoked at similar rates, except for a small bump in vaping among 17-year-old girls with ID. Paige’s adult data suggest the smoking gap widens later in life, pointing to adulthood as the key window for prevention.

Costa-Silva et al. (2025) and Ma et al. (2026) detail specific sleep problems—bruxism and REM deficits—in autistic kids. Paige shifts the lens to adults and ties sleep deficits to a health behavior, smoking, rather than to developmental markers.

If you run health groups for autistic adults, start by asking about sleep hours and sitting time before you jump to quit plans. Fixing short sleep and building movement breaks may make nicotine cravings easier to manage. Track these two variables weekly; small gains in sleep or step count could boost quit success more than pushing exercise alone.