WEDNESDAY, Sept. 11, 2002 (HealthDayNews) -- Martin Merrick, a 56-year-old New York City firefighter, has been smoking cigarettes since his early teens, but in all those years his strongest urge to smoke came right after the attacks on the World Trade Center.
In the city's tightly knit team of firefighters, Merrick knew 83 of the 343 firefighters who died in the disaster.
"My smoking went up. I'm sure of it," he says nearly a year later. "You don't realize it at first because you're busy, but then it hits you. I talked to another firefighter I know, and he said he started smoking like crazy after September."
The two men aren't alone. To deal with the stress and grief following the terrorist attacks, 29 percent of the smokers in the 11,000-person Fire Department of New York City admitted smoking more cigarettes; 23 percent of the ex-smokers said they had started again, according to data collected by the department's medical office.
The figures dovetail with estimates released this week by the New York City Department of Health that 75,000 people may have taken up the habit for the first time as a result of 9/11.
The disturbing trend didn't stop at the city line. Another survey found
21 percent of smokers increased their smoking in New York, New Jersey and Connecticut. One percent of nonsmokers started smoking and 3 percent of drinkers increased their alcohol intake, according to the Centers for Disease Control and Prevention.
However, among the firefighters, who are often exposed to carcinogens that can become much more damaging when coupled with smoking, the risks are extreme, says Dr. David J. Prezant, the fire department's deputy medical officer.
"Firefighting is one of the most stressful jobs in America. You come across death on a regular basis, unfortunately too regular," he says. "Most of these people who smoke want to stop smoking, now more than ever."
To help firefighters kick the habit, the department last month began offering a free stop-smoking course designed for firefighters. Merrick, who works in the medical examiner's office, is one of the 160 firefighters who have already started the weekly course.
"I've tried it before. I must have tried it 10 times or more, but it only lasts a week or so," Merrick says about his efforts to quit. This time, because of help from his comrades and his daughter's ultimatum that he can't visit his grandson if he smokes, the 30-year firefighter has held on longer than ever before.
"The first week was a little tough. I had a few cigarettes," he says. "But it's been about three weeks since I had a cigarette. It feels good."
The program relies on nicotine replacement therapies such as inhalers and patches; small group sessions to discuss cravings other aspects of quitting smoking, and medical monitoring of all participants. The department is also offering the program to spouses of the firefighters to root the behavior change in the family.
Prezant helped design the program after examining other smoking cessation initiatives. Other sponsors are the Chest Foundation and Pharmacia Corp., makers of the Nicotrol line of smoking cessation products.
"I can't take away their exposure from 9/11. I don't have a magic wand," Prezant says. "But I want to look forward the next 20 years for their health, and one of the most major modifiable behaviors is smoking."
Besides preventing the long-term dangers of smoking, there are other reasons for addressing the smoking trend by New York City firefighters and nearby residents, says David Vlahov, director of the New York Academy of Medicine's Center for Urban Epidemiological Studies. Smoking is just one sign of a panic attack that can also lead to depression and drug and alcohol abuse, which should also be treated.
"The World Trade Centers were a symbol for the city. To what extent did this affect the general attitude of the city?" Vlahov says. "We were wondering if there were going to be ripple effects to the disaster that continue to affect us."
For the New York City firefighters, the cessation program is so successful the fire department plans to expand it to bring in more of the 1,500 firefighters who smoke.
"Right now we have more people than we can handle. That's still only 10 percent of what we want to get, but every week we're starting a new program," Prezant says.
What To Do
For tips on stopping smoking, visit the Centers for Disease Control and Prevention. For a list of groups that run smoking cessation programs in your area, go here.
