Substance Use in NYC Increased After Sept. 11 Attacks

NEW YORK CITY, May 28 - Manhattan residents markedly increased their use of alcohol, cigarettes and marijuana in the weeks following the September 11 terrorist attacks on the World Trade Center, according to a new study by researchers at The New York Academy of Medicine. The study will appear in the June 1 issue of the American Journal of Epidemiology.

Academy researchers interviewed 988 Manhattan residents south of 110th Street in a random-digit dial phone survey, in the five to eight weeks after the attacks. Nearly 29 percent of those interviewed increased their intake of these three substances after the World Trade Center collapse. More Manhattan residents who were surveyed turned to alcohol than to any other substance: 24.6 percent of those surveyed reported drinking more than usual in the five to eight weeks after September 11. Cigarette smoking increased by 9.7 percent above the norm in that time period, and marijuana, by 3.2 percent.

Those who smoked more cigarettes and marijuana were dramatically more likely to experience post-traumatic stress disorder (PTSD) than those who did not, according to David Vlahov, Ph.D., director of the Academy's Center for Urban Epidemiologic Studies. Vlahov, who is also an adjunct professor at the Johns Hopkins University Bloomberg School of Public Health in Baltimore and at Columbia University, is lead author of the paper.

"This is one of the first studies immediately after a major disaster to show increases in substance use, especially cigarettes, in the general population," Vlahov said. "Follow-up studies are underway and data are emerging that the observed increase in cigarette use is continuing. This is a particular concern because of the highly addictive nature of tobacco."

Research findings show that 24.1 percent of those who smoked more cigarettes than usual after September 11 experienced PTSD, compared to 5.6 percent of those who did not. Similarly, 36 percent of those who smoked more marijuana experienced PTSD, compared to 6.6 percent of those whose marijuana consumption remained unchanged. PTSD symptoms include the prolonged occurrence of distressing dreams, efforts to avoid thoughts related to the tragedy, and difficulty falling asleep or concentrating.

Depression was also more common among those who increased cigarette smoking, alcohol consumption, and marijuana use than among those who did not. Among smokers, depression struck 21.1 percent of those whose habit intensified, compared to 8.2 percent of those whose smoking patterns remained stable. More than 15 percent of those who drank more alcohol than normal suffered from depression, compared to 8.3 percent of those who drank no more than usual. More than 22 percent of those who smoked more marijuana following the terrorist attacks reported being depressed, compared to 9.4 percent of those whose marijuana habits did not change.

The study was co-authored by: Vlahov; Sandro Galea, M.D., M.P.H., and Jennifer Ahern, M.P.H., both of the Academy's Center for Urban Epidemiologic Studies; Heidi Resnick, Ph.D., and Dean Kilpatrick, Ph.D., both of the National Crime Victims' Research and Treatment Center at the Medical University of South Carolina in Charleston; Joseph Boscarino, Ph.D., M.P.H., of the Academy's Division of Health and Science Policy; Michael Bucuvalas, Ph.D., M.P.H., of the research firm Schulman, Ronca & Bucuvalas, Inc.; and, Joel Gold, M.D., of the Bellevue Hospital Center. It was supported by grants from the National Institute on Drug Abuse, a division of the National Institutes of Health, as well as from The New York Community Trust and the United Way of New York City.

The New York Academy of Medicine is a non-profit organization founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on disadvantaged urban populations.

Posted on May 28, 2002

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