In a hidden health effect of terrorism, about 1 million former smokers in the United States started smoking again after the Sept. 11, 2001, terrorist attacks, a new study finds.
The research found that smoking increased 2.3 percent nationwide after the 9/11 attacks. The increase was maintained until the end of 2003, when the researchers' analysis of data ended.
The study also found especially high increases in stress levels after Sept. 11 in communities with higher percentages of active-duty and reserve members of the military, and among higher-educated people. The rise in stress levels accounted for all of the increase in smoking, said the researchers from the Weill Cornell Medical College in New York City.
"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," study author Michael Pesko, an instructor in the department of public health, said in a college news release. "It sheds light on a hidden cost of terrorism."
The findings were published online recently in the journal Contemporary Economic Policy.
"I was really surprised to find that former smokers across the nation resumed their old habit," Pesko said. "I was expecting to see impacts just in the New York City area or, at most, the tri-state area."
Pesko said the estimated cost to the government of increased smoking after Sept. 11 was between $530 million and $830 million, and may be higher if the smoking continued beyond 2003. The costs include Medicare and Medicaid expenses, productivity losses associated with smoking-related illnesses and decreased tax revenue from lost work.
The findings suggest a potential public health response to deal with stress caused by future terrorist attacks or disasters, Pesko said. One idea would be to offer free nicotine-replacement therapy soon after the event.
"Another strategy would be to alert health professionals to do more substance-abuse screening during regular medical appointments following terrorist attacks, or any such event that is likely to stress the nation," he said.
Pesko also looked at the aftermath of the 1995 Oklahoma City bombing but did not find an increase in smoking after that terrorist attack.