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

- We examined smoking over a 7-9 year period among WTC Health Registry enrollees.
- Smoking prevalence was higher among enrollees with PTSD than those without over the study period.
- Smokers with PTSD were less likely to quit smoking than smokers without.
- Smokers with PTSD may require extensive support in order to successfully quit smoking.

ObjectiveNumerous studies have observed higher rates of smoking among adults with mental health conditions. We examined posttraumatic stress disorder (PTSD) and smoking over a 7-9 year period among adults with firsthand exposure to the 9/11 attacks enrolled in the World Trade Center Health Registry.MethodData 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 30 days), 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.ResultsSmoking 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.ConclusionPTSD 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.