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American Journal of Epidemiology Vol. 155, No. 11 : 988-996
Copyright © 2002 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

Increased Use of Cigarettes, Alcohol, and Marijuana among Manhattan, New York, Residents after the September 11th Terrorist Attacks

David Vlahov1,2, Sandro Galea1,3, Heidi Resnick4, Jennifer Ahern1, Joseph A. Boscarino5, Michael Bucuvalas6, Joel Gold1,7 and Dean Kilpatrick4

1 Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY.
2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
3 Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
4 National Crime Victims' Research and Treatment Center, Medical University of South Carolina, Charleston, SC.
5 Division of Health and Science Policy, New York Academy of Medicine, New York, NY.
6 Schulman, Ronca, and Bucuvalas, Inc., New York, NY.
7 Bellevue Hospital Center, New York, NY.

The September 11, 2001, terrorist attacks were the largest human-made disaster in the United States since the Civil War. Studies after earlier disasters have reported rates of psychological disorders in the acute postdisaster period. However, data on postdisaster increases in substance use are sparse. A random digit dial telephone survey was conducted to estimate the prevalence of increased cigarette smoking, alcohol consumption, and marijuana use among residents of Manhattan, New York City, 5–8 weeks after the attacks. Among 988 persons included, 28.8% reported an increase in use of any of these three substances, 9.7% reported an increase in smoking, 24.6% reported an increase in alcohol consumption, and 3.2% reported an increase in marijuana use. Persons who increased smoking of cigarettes and marijuana were more likely to experience posttraumatic stress disorder than were those who did not (24.2% vs. 5.6% posttraumatic stress disorder for cigarettes; 36.0% vs. 6.6% for marijuana). Depression was more common among those who increased than for those who did not increase cigarette smoking (22.1 vs 8.2%), alcohol consumption (15.5 vs. 8.3%), and marijuana smoking (22.3 vs. 9.4%). The results of this study suggest a substantial increase in substance use in the acute postdisaster period after the September 11th attacks. Increase in use of different substances may be associated with the presence of different comorbid psychiatric conditions.

alcohol drinking; disasters; marijuana smoking; smoking; stress disorders, posttraumatic; substance-related disorders

Abbreviations: OR, odds ratio; PTSD, posttraumatic stress disorder; WTC, World Trade Center


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