Substance abuse increases in New York City in aftermath of September 11th

May 28, 2002

Survey results indicate that smoking and alcohol and marijuana use increased among residents of Manhattan during the five to eight weeks after the terrorist attacks on the World Trade Center (WTC).

Almost one-third of the nearly 1,000 persons interviewed reported an increased use of alcohol, marijuana, or cigarettes following the September 11th attacks. The largest increase was in alcohol use. About one-fourth of the respondents said they were drinking more alcohol in the weeks after September 11th; about 10 percent reported an increase in smoking, and 3.2 percent said they had increased their use of marijuana.

The survey results appear in the June 1, 2002 issue of the American Journal of Epidemiology. Dr. Glen R. Hanson, Acting Director of the National Institute on Drug Abuse (NIDA), says, "By helping to define the demographic and situational characteristics that were associated with increased alcohol, cigarette, and marijuana use following the traumatic events of September 11th, this research will help us to design more effective substance abuse treatment and prevention strategies for individuals coping with severe stress."

The investigators found survey participants by randomly dialing New York City phone numbers and screened potential respondents for Manhattan residents living in areas close to the World Trade Center. Interviews were conducted with 988 individuals between October 16th and November 15th, 2001 -- five to eight weeks after the terrorist attacks.

Demographic information was collected on each participant and the respondents were asked if they had experienced other major life stresses, such as a divorce or death in the family during the past year; if they had directly witnessed the events of September 11th; if they were afraid for their lives during the attacks; if friends or relatives were killed during the attacks; if they were involved in the rescue efforts; if they had experienced symptoms of panic in the "first few hours" after the attacks; and if they had lost a job or possessions as a result of the attacks. Participants were asked about their cigarette smoking, alcohol drinking, and marijuana use habits before and after September 11th. During the week prior to September 11, 2001, 22.6 percent of the participants reported smoking cigarettes, 59.1 percent drinking alcohol, and 4.4 percent using marijuana. After September 11th, 23.4 percent reported smoking cigarettes, 64.4 percent drinking alcohol and, 5.7 percent smoking marijuana. Among those who smoked, almost 10 percent reported smoking at least an extra pack of cigarettes a week and among those who drank alcohol, more than 20 percent reported imbibing at least one extra drink a day.

The research team, led by Drs. David Vlahov and Sandro Galea of the New York Academy of Medicine, found that people who reported an increase in substance abuse were more likely to suffer from post-traumatic stress disorder (PTSD) and from depression. People who reported an increase in cigarette smoking or marijuana use were also more likely to have both PTSD and depression, while those who reported an increase in alcohol use were more likely to have depression only.

Dr. Vlahov says, "Increased use of cigarettes, alcohol and other substances is a public health concern because these patterns are more frequent among those who have post-traumatic stress disorder and depression, and also because continued increased use has other medical consequences. Reversing these trends is an important goal."

Persons who were living closer to the World Trade Center were more likely to increase their cigarette smoking, but other factors such as being displaced from home, losing possessions during the attacks, or being involved in the rescue efforts were not consistently associated with increased substance use. Symptoms of panic attack were associated with an increase in the use of all substances.

Increase in substance abuse did not differ significantly between men and women or among racial or ethnic groups. Demographic factors such as age, marital status, and income seemed to play a more critical role in determining if the events of September 11th led to an increase in substance use. For example, among the demographic characteristics associated with increased alcohol consumption were age (more than 65 years of age), household income (less than $20,000 a year), and marital status (divorced, separated, or widowed).
This study was funded by grants from NIDA, the United Way of New York City, and The New York Community Trust.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports more than 85 percent of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and other topics can be ordered free of charge in English and Spanish through NIDA Infofax at 1-888-NIH-NIDA (644-6432) or 1-888-TTY-NIDA (889-6432) for the deaf. These fact sheets and further information on NIDA research and other activities can be found on the NIDA home page at

NIH/National Institute on Drug Abuse

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