Exposure to the World Trade Center attack and the use of cigarettes and alcohol among New York City public high-school students.

We examined exposure to the World Trade Center attack and changes in cigarette smoking and drinking among 2731 New York City public high-school students evaluated 6 months after the attack. Increased drinking was associated with direct exposure to the World Trade Center attack (P < .05). Increased smoking was not directly associated with exposure to the World Trade Center attack but was marginally significantly associated with posttraumatic stress disorder (P= .06). Our findings suggest that targeted substance-use interventions for youths may be warranted after large-scale disasters.