Dalisay Francis, Hong Young-Rock, Chu Haoran, Salloum Ramzi G
College of Journalism and Communications, STEM Translational Communication Center, University of Florida, Gainesville, United States.
Department of Family and Preventive Medicine, Emory University School of Medicine, Emory University, Atlanta, United States.
Tob Induc Dis. 2025 Apr 30;23. doi: 10.18332/tid/203427. eCollection 2025.
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.
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.
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.
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.
自然灾害会增加慢性病患者的健康风险，并可能使物质使用行为作为一种应对机制而恶化。本研究调查了经历过海伦娜飓风和米尔顿飓风的慢性病患者灾后使用香烟和电子烟的意图、过去30天内的使用情况以及相关因素。
在海伦娜飓风过后，我们在美国佐治亚州、北卡罗来纳州和南卡罗来纳州以及海伦娜/米尔顿飓风过后（2024年10月至11月）在佛罗里达州联邦紧急事务管理局（FEMA）宣布的受灾县进行了在线小组调查。研究参与者（n = 418）包括自我报告诊断患有糖尿病、心脏病、肺部/呼吸道疾病或癌症的成年人。我们采用了经过验证的飓风压力源、心理困扰（抑郁/焦虑）和气候变化焦虑的测量方法。使用多元逻辑回归模型来研究与使用香烟和电子烟的意图以及过去30天内使用情况相关的因素。
飓风压力源一直与增加使用香烟和电子烟的意图以及当前使用情况相关（调整后的比值比范围为1.21至1.36，所有p < 0.001）。抑郁/焦虑症状与灾后使用香烟的意图增加相关（调整后的比值比 = 1.91；95%置信区间：1.38 - 2.64，p < 0.001）以及使用电子烟的意图增加相关（调整后的比值比 = 1.66；95%置信区间：1.21 - 2.28，p < 0.01），还与过去30天内使用香烟相关（调整后的比值比 = 1.49；95%置信区间：1.10 - 2.02，p < 0.05）。气候变化焦虑（调整后的比值比 = 1.41；95%置信区间：1.07 - 1.85，p < 0.05）与过去30天内使用电子烟增加相关。
除了飓风压力源以及抑郁和焦虑症状外，气候变化焦虑似乎是与烟草使用相关的一个因素，尤其是电子烟。灾后健康评估应纳入针对慢性病弱势群体的物质使用干预措施。
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