title: Posttraumatic stress symptoms and smoking among World Trade Center disaster responders: A longitudinal investigation.
abstract: OBJECTIVE
  The current longitudinal study examined posttraumatic stress disorder (PTSD) symptom severity in relation to smoking abstinence and reduction over time among responders to the World Trade Center (WTC) disaster.
  
  
  METHODS
  Participants were 763 police and 1881 non-traditional (e.g., construction workers) WTC responders who reported being smokers at an initial examination obtained between July 2002 and July 2011 at the WTC Health Program (WTC-HP). WTC responders were reassessed, on average, 2.5 years later.
  
  
  RESULTS
  For police WTC responders, higher levels of WTC-related PTSD symptoms at the initial visit were associated with a decreased likelihood of smoking abstinence (OR=0.98, p=.002) and with decreased smoking reduction (β=-.06, p=.012) at the follow-up visit. WTC-related PTSD symptom severity was not related to likelihood of smoking abstinence or change in number of cigarettes smoked among non-traditional responders. Post hoc analyses suggested that for police, hyperarousal PTSD symptoms were predictive of decreased abstinence likelihood at the follow-up visit (OR=0.56, p=.006).
  
  
  CONCLUSIONS
  The present findings suggest that PTSD symptoms may be differentially related to smoking behavior among police and non-traditional WTC responders in a naturalistic, longitudinal investigation. Future work may benefit from exploring further which aspects of PTSD (as compared to each other and to common variance) explain smoking maintenance.
authors.affiliation: Department of Psychology, University of Houston, Houston, TX, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address: mjzvolen@central.uh.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zvolensky
authors.affiliation: Department of Psychology, University of Houston, Houston, TX, United States.
authors.forename: Samantha G
authors.initials: SG
authors.lastname: Farris
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States.
authors.forename: Roman
authors.initials: R
authors.lastname: Kotov
authors.affiliation: Department of Family & Social Medicine, Albert Einstein College of Medicine, Bronx, NY, United States.
authors.forename: Clyde B
authors.initials: CB
authors.lastname: Schechter
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Bromet
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States.
authors.forename: Adam
authors.initials: A
authors.lastname: Gonzalez
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States.
authors.forename: Anka
authors.initials: A
authors.lastname: Vujanovic
authors.affiliation: VA Connecticut Healthcare System, United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, West Haven, CT, United States; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Crane
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, United States.
authors.forename: Julia
authors.initials: J
authors.lastname: Kaplan
authors.affiliation: Department of Population Health, North Shore-LIJ Health System, Great Neck, NY, United States.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Moline
authors.affiliation: VA Connecticut Healthcare System, United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, West Haven, CT, United States; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Southwick
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Adriana
authors.initials: A
authors.lastname: Feder
authors.affiliation: Environmental and Occupational Health Sciences Institute, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States.
authors.forename: Iris
authors.initials: I
authors.lastname: Udasin
authors.affiliation: WTC Health Program, NIOSH, Washington, DC, United States.
authors.forename: Dori B
authors.initials: DB
authors.lastname: Reissman
authors.affiliation: Department of Medicine, Stony Brook University, Stony Brook, NY, United States.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Luft
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004190:Disasters; D060731:Emergency Responders / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016495:Police / Q000523:psychology; D047851:September 11 Terrorist Attacks / Q000523:psychology* / Q000639:trends; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*