Tobacco induced diseases · 2025
Factors associated with smoking and e-cigarette use statuses among individuals with chronic diseases after hurricanes Helene and Milton.
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Dalisay Francis, Hong Young-Rock, Chu Haoran, Salloum Ramzi G
Аннотация
INTRODUCTION: Natural disasters increase health risks for individuals with chronic diseases and may worsen substance use behaviors as a coping mechanism. The present study examined post-disaster intentions to use and past 30-day use of cigarettes and e-cigarettes and associated factors among individuals with chronic diseases who experienced hurricanes Helene and Milton.
METHODS: We conducted online panel surveys in US Federal Emergency Management Agency (FEMA)-declared disaster counties in Georgia, North Carolina, and South Carolina following hurricane Helene, and in Florida following Helene/Milton (October-November 2024). Study participants (n=418) included adults with self-reported diagnoses of diabetes, heart disease, lung/respiratory disease, or cancer. We employed validated measures of hurricane stressors, psychological distress (depression/anxiety), and climate change anxiety. Multiple logistic regression models were used to examine factors associated with intentions to use and past 30-day use of cigarettes and e-cigarettes.
RESULTS: Hurricane stressors were consistently associated with increased intentions and current use of both cigarettes and e-cigarettes (AORs ranging from 1.21 to 1.36, all p<0.001). Depression/anxiety symptoms were associated with increased post-disaster intentions to use cigarettes (AOR=1.91; 95% CI: 1.38-2.64, p<0.001) and e-cigarettes (AOR=1.66; 95% CI: 1.21-2.28, p<0.01), and past 30-day use of cigarettes (AOR=1.49; 95% CI: 1.10-2.02, p<0.05). Climate change anxiety (AOR=1.41; 95% CI: 1.07-1.85, p<0.05) was associated with increased past 30-day e-cigarette use.
CONCLUSIONS: In addition to hurricane stressors and depression and anxiety symptoms, climate change anxiety appears to be a factor associated with tobacco use, particularly, e-cigarettes. Post-disaster health assessments should incorporate substance use interventions for vulnerable populations with chronic conditions.
METHODS: We conducted online panel surveys in US Federal Emergency Management Agency (FEMA)-declared disaster counties in Georgia, North Carolina, and South Carolina following hurricane Helene, and in Florida following Helene/Milton (October-November 2024). Study participants (n=418) included adults with self-reported diagnoses of diabetes, heart disease, lung/respiratory disease, or cancer. We employed validated measures of hurricane stressors, psychological distress (depression/anxiety), and climate change anxiety. Multiple logistic regression models were used to examine factors associated with intentions to use and past 30-day use of cigarettes and e-cigarettes.
RESULTS: Hurricane stressors were consistently associated with increased intentions and current use of both cigarettes and e-cigarettes (AORs ranging from 1.21 to 1.36, all p<0.001). Depression/anxiety symptoms were associated with increased post-disaster intentions to use cigarettes (AOR=1.91; 95% CI: 1.38-2.64, p<0.001) and e-cigarettes (AOR=1.66; 95% CI: 1.21-2.28, p<0.01), and past 30-day use of cigarettes (AOR=1.49; 95% CI: 1.10-2.02, p<0.05). Climate change anxiety (AOR=1.41; 95% CI: 1.07-1.85, p<0.05) was associated with increased past 30-day e-cigarette use.
CONCLUSIONS: In addition to hurricane stressors and depression and anxiety symptoms, climate change anxiety appears to be a factor associated with tobacco use, particularly, e-cigarettes. Post-disaster health assessments should incorporate substance use interventions for vulnerable populations with chronic conditions.