Population-Based Assessment of Post-Katrina Smoking Relapse

描述（由申请人提供）：在美国，每年有数百万人受到地震、洪水、飓风、龙卷风和野火等自然灾害的影响。这些毁灭性事件的幸存者经历了多重压力源，包括死亡或身体伤害的危险以及失去社区、家园、工作和财产。在这类灾难之后，与压力有关的心理症状和障碍很常见，特别是在难民等最直接受影响的人群中，包括抑郁、焦虑、创伤后应激障碍和增加使用精神活性物质，如酒精、大麻和香烟。吸烟是一种常见的精神活性物质使用形式，23%的美国成年人经常吸烟，这与压力密切相关。吸烟者经常报告吸烟是为了减轻压力和负面影响，而以前的吸烟者中复发通常是对压力和负面影响的反应。与其他药物滥用类似，再次吸烟仍然是一个巨大的挑战，只有2.5-7.5%的戒烟者保持长期戒断（CDC, 1996）。鉴于预防吸烟复吸对公共卫生的重要性，以及吸烟复吸与压力之间的密切联系，令人惊讶的是，没有关于灾难后吸烟复吸的数据。最近对2001年9月11日恐怖袭击时居住在世界贸易中心附近的曼哈顿居民的调查数据显示，大量吸烟者（特别是那些最直接受到袭击影响的人，例如失业）在袭击发生后的5-8周内增加了他们的每日吸烟率，并且这种增加持续了至少6-9个月。然而，没有关于吸烟复发率或特征的数据。因此，我们建议进行形成性工作和以人口为基础的纵向控制调查，使用电话访谈，比较受卡特里娜飓风影响最严重的前吸烟者（新奥尔良居民）和附近社区未受飓风严重影响的居民（田纳西州孟菲斯）的复发率和特征。研究问题包括：(1)与未受飓风严重影响的个体相比，卡特里娜飓风受害者中吸烟复发的患病率和时间进程是什么？(2)灾后吸烟复吸的诱发因素、促发因素和持久因素是什么？(3)卡特里娜飓风后复发的人重新尝试戒烟的动机和信心如何？(4)再次尝试戒烟的流行程度和时间进程如何？

DESCRIPTION (provided by applicant): Each year in the U.S., millions of people are affected by natural disasters such as earthquakes, floods, hurricanes, tornados, and wildfires. Survivors of these devastating events experience multiple stressors, including the danger of death or physical injury and the loss of their communities, homes, jobs, and possessions. Stress-related psychological symptoms and disorders are common after such disasters, especially among those most directly affected, such as refugees, and include depression, anxiety, posttraumatic stress disorder, and increased use of psychoactive substances, such as alcohol, marijuana, and cigarettes. Cigarette smoking is a common form of psychoactive substance use, engaged in regularly by 23% of U.S. adults, that is strongly associated with stress. Smokers often report smoking to reduce stress and negative affect, and relapse among former smokers commonly occurs as a response to stress and negative affect. Similar to other drugs of abuse, relapse to smoking remains a formidable challenge, with only 2.5-7.5% of quitters maintaining long term abstinence (CDC, 1996). Given the public health importance of preventing smoking relapse, and the strong association between smoking relapse and stress, it is surprising that no data are available on smoking relapse following disasters. Recent survey data from Manhattan residents living in the vicinity of the World Trade Center at the time of the September 11, 2001 terrorist attacks, show that substantial numbers of smokers (especially those most directly affected by the attacks, e.g., job loss) increased their daily smoking rate 5-8 weeks after the attack, and this increase persisted for at least 6-9 months. No data, however, are available on smoking relapse prevalence or characteristics. As such, we propose to conduct formative work and a population-based, longitudinal, controlled survey using a telephone interview, comparing relapse rates and characteristics among former smokers who were most severely impacted by Hurricane Katrina (New Orleans residents) and residents of a nearby community that was not severely impacted by the hurricane (Memphis, TN). Research questions include: (1) What is the prevalence and time course of smoking relapse among Katrina victims compared to individuals not severely impacted by the hurricane? (2) What predisposing, precipitating, and perpetuating factors act as mediators and moderators of post-disaster smoking relapse? (3) How motivated and confident are individuals who relapsed after Katrina to make a renewed quit attempt? and (4) What is the prevalence and time course of renewed quit attempts?