Longitudinal study of smoking cessation among World Trade Center Health Registry enrollees, 2003-2021

Individuals with post-traumatic stress disorder (PTSD) are more likely to smoke and less likely to quit smoking than people without the condition. Building upon previous research, we examined associations between probable PTSD and smoking cessation among World Trade Center Health Registry (WTCHR) enrollees, who have a relatively high prevalence of PTSD.

We used five waves of survey data (2003-2021) from the WTCHR, a closed cohort of 9/11-exposed individuals, to examine longitudinal associations between probable PTSD and subsequent smoking cessation among enrollees who reported current smoking. Probable PTSD was assessed with the PTSD Checklist for DSM-IV (PCL-S). The outcome of smoking cessation was also assessed via survey responses at the subsequent wave. Multivariable-adjusted risk ratios (RRs) and 95 % confidence intervals (95 % CI) were estimated with generalized estimating equations.

Overall, 31.3 % of enrollees quit smoking by the subsequent survey wave. Differences by probable PTSD status were observed, and in multivariable adjusted models, enrollees with probable PTSD were 8 % less likely to quit smoking compared to enrollees without probable PTSD (RR=0.92, 95 % CI: 0.87, 0.97).

Although various smoking cessation programs have been implemented among the WTC-exposed population, differences in cessation by PTSD status persist. Additional efforts to promote cessation among this group should consider mental health conditions.