In 9/11 aftermath, many former smokers returned to tobacco

It goes without saying that the Sept. 11 terror attacks shook the entire nation, but a newly released study documents one reverberation from the 2001 events that many probably haven’t considered before. A Weill Cornell Medical College public health study attributes a 2.3% nationwide—not just East Coast—rise in smoking to the stress that ensued from the 2001 attacks.

Reviewing data reported on by the Centers for Disease Control and Prevention (CDC) from the Behavioral Risk Factor Surveillance System, medical college instructor Michael F. Pesko was able to determine that from the fourth quarter of 2001 to the end of 2003, somewhere between 950,000 and 1.3 million adult former smokers resumed smoking.

The social costs of that smoking, based largely on Medicaid and Medicare expenses and the effects of lost productivity, likely ranged from $530 million to $830,000 million, and the number could be higher if more former smokers resumed smoking after 2003. Pesko’s findings are published in the June 20 issue of the journal Contemporary Economic Policy.

The research found that increased stress accounted for the rise in smoking, and that stress levels were especially elevated in communities that had large numbers of active-duty military and reserve members.

“This study provides the first unbiased estimate of the effect of stress on smoking, and the finding that there was such a big increase in smoking nationwide, seemingly due to one event, is extraordinary, and surprising,” says Pesko. “It sheds light on a hidden cost of terrorism.”

Pesko adds that prior to conducting the research, he would have expected to have seen a significant smoking increase post-9/11 in the New York City area, but not all across the country.

The research also explored risk behaviors following the 1995 Oklahoma City bombing, with that event showing no association with subsequent smoking rates.

Pesko suggests that the findings about 9/11 could signal the need to step up substance use assessments at times following major national tragedies. Another possibly productive intervention, he suggested, would involve making free nicotine replacement therapies available at these times.