Post-disaster mental health
worse in smokers
February 21, 2007
NEW YORK (Reuters Health) - Among people who experience a major disaster, smokers are more likely to develop mental health disturbances than those who don't smoke, according to a study published in the Journal of Clinical Psychiatry.
"Post-trauma mental health disturbances such as post-traumatic stress disorder (PTSD) are associated with increased smoking, either by starting to smoke or an increase of tobacco use," write Dr. Peter G. Van der Velden, of the Institute for Psychotrauma, Zaltbommel, the Netherlands, and colleagues.
However, few trauma studies have examined whether smoking is a risk factor, or "marker" for PTSD or other mental health disorders following a disaster.
To look into that aspect, the researchers conducted surveys 18 months and 4 years after a fireworks disaster in Enschede, the Netherlands. Included were 662 adult victims and 526 residents of another Dutch city who were used as a comparison group.
Victims who smoked at the first evaluation 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 at the 4-year evaluation.
While smoking was not a risk factor for mental illness in the overall comparison group, in a subgroup of individuals who had stressful life events, smoking at the first evaluation was associated with four times the risk of developing severe anxiety symptoms.
If these findings are confirmed by other studies, disaster victims who smoke may be able to reduce their risk of developing mental health disturbances if they quit smoking, Van der Velden and colleagues conclude.
SOURCE: Journal of Clinical Psychiatry, January 2007.
Online story source: http://news.yahoo.com/s/nm/20070222/hl_nm/post_disaster_smokers_dc_1
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Smoking as a risk factor for mental health disturbances after a disaster: a prospective comparative study.
Journal of Clinical Psychiatry. 2007 January;68(1): pages 87-92.
Authors: Van der Velden PG, Grievink L, Olff M, Gersons BP, Kleber RJ; Dutch Ministry of Health, Welfare, and Sport.
Institute for Psychotrauma, Zaltbommel, The Netherlands. firstname.lastname@example.org
OBJECTIVE: To assess whether smoking is a(n) (independent) risk factor for mental health problems among adult disaster victims and among a nonexposed comparison group.
METHOD: Surveys were conducted 18 months (T1) and 4 years (T2) after a fireworks disaster in Enschede, the Netherlands (May 13, 2000), among adult victims (N = 662) and a comparison group (N = 526) of residents of a city located in another part of the Netherlands. The surveys included measures of smoking (Dutch Local and National Public Health Monitor); severe anxiety, depression, and hostility symptoms (the Symptom Checklist-90, revised); and disaster-related post-traumatic stress disorder (PTSD; DSM-IV criteria) (the PTSD self-rating scale).
RESULTS: Victims who smoked at T1 had a higher chance to suffer from severe anxiety symptoms (adjusted OR = 2.32 [95% CI = 1.19 to 4.53]), severe hostility symptoms (adjusted OR = 1.84 [95% CI = 1.06 to 3.22]), and disaster-related PTSD (adjusted OR = 2.64 [95% CI = 1.05 to 6.62]) at T2 than victims who did not smoke at T1, when controlling for symptoms at T1, demographic characteristics, and life events. Among the total comparison group, smoking was not an independent risk factor. However, smoking at T1 was associated with severe anxiety symptoms at T2 among controls who were confronted with stressful life events (adjusted OR = 4.11 [95% CI = 1.03 to 16.47]).
CONCLUSIONS: Smoking is an independent risk factor for severe anxiety and hostility symptoms and PTSD among adult disaster victims and for anxiety symptoms among adult people who are confronted with stressful life events. Questions about smoking behavior among disaster victims may help to identify adult victims who are at risk for postevent mental health disturbances.
PMID: 17284135 [PubMed - indexed for MEDLINE]