Changes in Smoking Behavior After the Kahramanmaraş Earthquake Among Healthcare Workers at Three Different Hospitals in the Disaster-Affected Region
Abstract
Introduction and Objectives: This study aimed to evaluate changes in smoking among healthcare workers in the disaster-affected region following Kahramanmaraş earthquakes and to examine associations with anxiety, depression, post-traumatic stress symptoms, and nicotine dependence.
Method: This cross-sectional study was conducted between 1.12.2024-31.01.2025 with 151 healthcare workers employed at three hospitals in earthquake region (4.7% of all employees). Data were collected through face-to-face interviews using a questionnaire. All participants completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Impact of Event Scale (IES). Participants with a smoking history were assessed using Fagerström Test for Nicotine Dependence (FTND). Statistical analyses were performed using Python(Python 3.x), and p<0.05 was considered statistically significant.
Findings: Of 151 participants, 63 (41.7%) were men and 88 (58.3%) were women; mean age was 32.24±8.53 years. Fifty-five (36.4%) had a smoking history, and 27 of them (49.1%) reported increased smoking after the earthquake. Nicotine dependence and anxiety were higher in the increased-smoking group, whereas no differences were observed in depressive or post-traumatic stress symptom severity. In regression analyses adjusted for age and sex, increased smoking was associated with higher FTND and BAI scores. The frequency of having an IES score above the clinically meaningful threshold was higher among smokers. The proportion of participants not attempted to quit smoking increased after the earthquake.
Conclusion: The increased smoking in post-earthquake period at the three hospitals is noteworthy and is unlikely to be explained by trauma alone; nicotine dependence and anxiety may contribute. Healthcare workers should be included in post-disaster smoking cessation and mental health services.
Keywords
Earthquakes, Smoking, Anxiety, Post Traumatic Stress Disorder, Hospital Staff
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