Tobacco use after experiencing a major natural disaster: analysis of a longitudinal study of 2063 young adults

AIM: To identify the extent to which tobacco use is affected by experience of a natural disaster and resulting symptoms of post-traumatic stress disorder (PTSD). DESIGN: Longitudinal community survey. SETTING: Canberra, the national capital of Australia. PARTICIPATION: A random selection of 2063 young adults participating in this project lived in a region affected by a major bushfire in 2003. They were first interviewed in 1999-2000 and re-interviewed in 2003-4 after the bushfire had occurred. MEASUREMENTS: Changes in participants' level of consumption of tobacco over a 4-year period were calculated. When interviewed after the disaster, participants answered questions concerning their experience of traumatic events, their immediate emotional response during the disaster and their fire-related PTSD symptoms of re-experiencing and hyperarousal. FINDINGS: Experience of traumatic events experienced during the disaster was associated with an increase in consumption of tobacco (OR: 1.12, 95% CI: 1.03-1.21). PTSD symptoms did not contribute independently to increased tobacco use after controlling for trauma experiences. CONCLUSIONS: These findings indicate that trauma experiences can trigger increased tobacco use in young adults regardless of whether such experiences result in PTSD symptoms. Public health information provided to communities and health-care providers should note that increases in this preventable health risk may occur as a result of individuals experiencing trauma.