The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72493

William G Fernandez, MD, MPH¹, Sandro Galea, MD, MPH², William Chiang, MD³, Nealia Khan, BA⁴, Liz Kennedy, BS, MBA¹, Joanna Garritano, BS³, and David Vlahov, PhD². (1) Division of Emergency Medicine, New York Presbyterian Hospital, Columbia University, 622 West 168th Street, PH 137, New York City, NY 10032, 212.305.2995, billmanfernandez@hotmail.com, (2) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, (3) Division of Emergency Medicine, Bellevue Hospital Center, New York University, 462 1st Ave and 27th Streets, New York, NY 10016, (4) Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168 St, New York, NY 10032

INTRODUCTION: Research has documented short-term increases in substance use after large disasters. We sought to assess the relationship between the September 11, 2001 terrorist attacks and post-disaster alcohol and tobacco use among emergency department (ED) patients in New York City (NYC) approximately one year after the event. METHODS: We conducted a cross-sectional questionnaire study July – October 2002 in two university hospitals EDs in NYC. A systematic sample of stable, adult patients was enrolled. We used a self-administered questionnaire format to determine alcohol and tobacco use and relevant covariates. Statistical analysis was done using Chi-square and logistic regression. RESULTS: 433 (52.7% females, 48.3% males) participated. Response rate was 73.4%. 132 (31.8%) respondents reported having been exposed to the September 11 attacks. 234 (54.0%) reported current alcohol consumption; 111 (25.6%) reported current tobacco use. 39% of respondents reported they were smoking more cigarettes, and 24% reported that they were drinking more alcohol currently than they were before September 11. In separate multivariable models, persons who had been exposed to the September 11 terrorist attacks were more likely to report that they were smoking more cigarettes (OR=2.4; 95% CI=1.2-4.5), and drinking more alcohol (OR=1.9; 95%CI=1.1-3.5) after the attacks than those who were not exposed to the attacks. CONCLUSIONS: A year after September 11, 2001, a substantial proportion of ED patients in NYC had increased alcohol and tobacco use. The behavioral consequences of traumatic events should be considered in the evaluation of ED patients after large disasters.

Learning Objectives:

• To discuss the research on the association between traumatic experiences and subsequent increases in substance use.
• To document the relationship between the September 11, 2001 attacks and subsequent increases in alcohol and tobacco use

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.