Cigarette smoking and 9/11-related posttraumatic stress disorder among World Trade Center Health Registry enrollees, 2003-12

Prev Med. 2015 Apr:73:94-9. doi: 10.1016/j.ypmed.2015.01.023. Epub 2015 Feb 2.

Abstract

Objective: Numerous studies have observed higher rates of smoking among adults with mental health conditions. We examined posttraumatic stress disorder (PTSD) and smoking over a 7-9year period among adults with firsthand exposure to the 9/11 attacks enrolled in the World Trade Center Health Registry.

Method: Data were collected at three waves: W1 (2003-04), W2 (2006-07), and W3 (2011-12). Enrollees aged ≥25 at W1 and who completed all three waves (n=34,458) were categorized by smoker-type: non-smoker, non-daily (smoked some days in last 30days), light (1-10 cigarettes per day (CPD)), or heavy (11+ CPD). Enrollees who smoked at W1 but not W3 were considered to have quit. PTSD was defined as a score of ≥44 on the PTSD Checklist-Civilian Version.

Results: Smoking declined significantly from W1 (12.6%) to W3 (9.2%). Smoking prevalence was higher among enrollees with PTSD. In multivariable models, odds of quitting were 25-39% lower among heavy, light, and non-daily smokers with PTSD compared to those without.

Conclusion: PTSD was associated with reduced odds of quitting regardless of smoker-type. Disaster-exposed smokers with PTSD are likely in need of more supportive services in order to abstain from smoking.

Keywords: 9/11; Disaster; PTSD; Posttraumatic stress disorder; Smoking; Smoking cessation; WTC; World Trade Center.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • New York City / epidemiology
  • Registries
  • September 11 Terrorist Attacks / psychology*
  • September 11 Terrorist Attacks / statistics & numerical data
  • Smoking / epidemiology*
  • Smoking / psychology
  • Stress Disorders, Post-Traumatic / complications
  • Stress Disorders, Post-Traumatic / psychology*