Treatment Online

Smokers Suffer More After Disasters?
> 2/22/2007 10:50:12 AM

Reuters has reported on a new study that seems to indicate that tobacco use in the wake of a major disaster may be a risk factor for developing mental health problems after the event. By interviewing citizens of two Dutch cities--one, Enshede, the site of a massive fireworks explosion that killed 23 and injured nearly a thousand, and the other a control city--the researchers examined whether those that smoked 18 months after the incident (T1) sustained higher levels of mental health problems 4 years removed from the event (T2). Smokers in the study's test group showed significantly higher levels of PTSD and other anxiety disorders than those who did not use tobacco.

According to Reuters, the group found that those who were smokers at T1 "were more than twice as likely as those who did not smoke to have severe anxiety symptoms, nearly twice as likely to have severe hostility symptoms, and close to three times as likely to have a diagnosis of disaster-related PTSD," when they were interviewed at T2. The report, which appears in The Journal of Clinical Psychiatry (who unfortunately make even their abstracts unavailable to the public), stipulates that other studies have shown that tobacco use typically increases after a disaster, in the form of both increased usage by current smokers as well as a rise in total number of users. This study however, indicates that tobacco might be a marker or risk factor for future mental health problems in the form of PTSD or other anxiety related disorders.

While this information could prove useful after further supportive research, the trouble with this study is in its ambiguousness. It's unclear, at least from the Reuters report whether duration of tobacco use was factored in to the analysis. Were those in Enshede who smoked at T1 smokers before the disaster? Did new smokers experience an even greater increase over long-time users, was it the opposite or did duration of use have no effect? Did amount of tobacco used effect the changes? Did residents from the control city who used tobacco also display any problems dealing with stress or anxiety? Some of these questions are next to impossible to answer simply by design, but others could play a critical role in further explaining the relationship between tobacco usage and mental health struggles after a traumatic event.

What we might surmise from this short, and albeit unscientific write up, is that tobacco and smoking function as a self-medicating technique following a disaster, with those who already smoke, smoking more, and those who don't smoke, taking up the habit. This might then prevent those disaster victims from dealing with the stresses and anxieties that happen to everyone after a disaster in healthy and productive ways. Obviously, this will require more time and energy before a definitive answer can be reached, but this early look shows that this is indeed something to be explored.

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