Among people who experience a major disaster, smokers are more likely to develop mental health disturbances than those who don't smoke, according to a study published in the Journal of Clinical Psychiatry.

"Post-trauma mental health disturbances such as post-traumatic stress disorder (PTSD) are associated with increased smoking, either by starting to smoke or an increase of tobacco use," write Dr. Peter G. Van der Velden, of the Institute for Psychotrauma, Zaltbommel, the Netherlands, and colleagues.

However, few trauma studies have examined whether smoking is a risk factor, or "marker" for PTSD or other mental health disorders following a disaster.

To look into that aspect, the researchers conducted surveys 18 months and 4 years after a fireworks disaster in Enschede, the Netherlands. Included were 662 adult victims and 526 residents of another Dutch city who were used as a comparison group.

Victims who smoked at the first evaluation were more than twice as likely as those who did not smoke to have severe anxiety symptoms, nearly twice as likely to have severe hostility symptoms, and close to three times as likely to have a diagnosis of disaster-related PTSD at the 4-year evaluation.

While smoking was not a risk factor for mental illness in the overall comparison group, in a subgroup of individuals who had stressful life events, smoking at the first evaluation was associated with four times the risk of developing severe anxiety symptoms.

If these findings are confirmed by other studies, disaster victims who smoke may be able to reduce their risk of developing mental health disturbances if they quit smoking, Van der Velden and colleagues conclude.

SOURCE: Journal of Clinical Psychiatry, January 2007.