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. Am J Epidemiol 2002;155:988–96.
Peer Reviewed
http://deepblue.lib.umich.edu/bitstream/2027.42/40268/2/Vlahov_Increased Use of Cigarettes, Alcohol, and Marijuana_2002.pdf