Longitudinal changes in mental health associated with increased tobacco and alcohol use in a displaced population

Research has shown that stress and mental health are often associated with alcohol use and smoking. However, long-term studies of this association in a displaced population are limited. This study investigates the changes in mental health (measured with the mental component summary (MCS) score of the SF-12) associated with increased smoking and alcohol use based on four waves of data collected from a longitudinal cohort study of 1,079 respondents displaced or greatly affected by Hurricane Katrina. Results showed nearly one-third of respondents reported using either tobacco or alcohol more than before the hurricane. Among current smokers, over half reported smoking more now than they did before Katrina; one quarter of respondents consuming any alcohol in the previous six months indicated they were drinking more. Results from the CAGE Assessment (Ewing, 1984) found one in ten current users may have an alcohol problem. Using a mixed-effects growth curve model controlling for housing stability, family structure, socioeconomic status, and location of residence, we found respondents that smoked more since Katrina had a mental health component (MCS) score 2.79 points lower than those that did not smoke more (p<0.05). MCS scores were 4.47 points lower for respondents that drank more compared to those that did not. A higher CAGE Assessment score significantly reduced MCS score an additional 0.70 points over time and drinking more since Katrina was associated with a further decrease in MCS score of 1.47 points over time.