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We assessed potential risk factors for acute mental health symptoms and tobacco initiation among U.S. Coast Guard responders to the 2010 <jats:italic>Deepwater Horizon<\/jats:italic> (DWH) oil spill who completed a deployment exit survey. Cross\u2010sectional associations among responder characteristics, deployment\u2010related stressors (deployment duration, timing, crude oil exposure, physical symptoms, injuries), and professional help\u2010seeking for stressors experienced with concurrent depression\/anxiety and tobacco initiation were examined. Log\u2010binomial regression was used to calculate adjusted prevalence ratios (a<jats:italic>PR<\/jats:italic>s) and 95% confidence intervals. Sensitivity analyses excluded responders with a history of mental health conditions using health encounter data from the Military Health System Data Repository. Of the 4,855 responders, 75.5% were deployed from nonlocal\/non\u2010Gulf home stations, 5.8% reported concurrent depression and anxiety, and 2.8% reported the initiation of any tobacco product during oil spill response. Self\u2010report of concurrent depression and anxiety was more prevalent among female responders and positively associated with longer deployments, crude oil exposure via inhalation, physical symptoms and injuries, and professional help\u2013seeking during deployment, a<jats:italic>PR<\/jats:italic>s = 1.54\u20136.55. Tobacco initiation was inversely associated with older age and officer rank and positively associated with deployment\u2010related stressors and depression\/anxiety during deployment, a<jats:italic>PR<\/jats:italic>s = 1.58\u20134.44. Associations remained robust after excluding responders with a history of mental health\u2013 and tobacco\u2013related health encounters up to 3 years before deployment. Depression, anxiety, and tobacco initiation were cross\u2010sectionally associated with oil spill response work experiences among DWH responders, who largely originated outside of the affected community.<\/jats:p>","DOI":"10.1002\/jts.22817","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T18:28:06Z","timestamp":1647368886000},"page":"1099-1114","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Risk factors for acute mental health symptoms and tobacco initiation in Coast Guard Responders to the <i>Deepwater Horizon<\/i> oil spill"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7303-1874","authenticated-orcid":false,"given":"Jeanny H.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine and Biostatistics Uniformed Services University  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hristina","family":"Denic\u2010Roberts","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Biostatistics Uniformed Services University  Bethesda Maryland USA"},{"name":"Oak Ridge Institute for Science and Education  Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Goodie","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology Uniformed Services University  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana L.","family":"Thomas","sequence":"additional","affiliation":[{"name":"United States Coast Guard Headquarters Directorate of Health, Safety, and Work Life  Washington D.C. USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence S.","family":"Engel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Public Health University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Rusiecki","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Biostatistics Uniformed Services University  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jat.1521"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yfrne.2014.05.004"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleh.2015.09.010"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1021\/es5012862"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0016608"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxu007"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2007.034777"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.01.022"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2018.120"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11414\u2010014\u20109418\u20107"},{"key":"e_1_2_7_12_1","volume-title":"Building community resilience to large oil spills: Findings and recommendations from a synthesis of research on the mental health, economic, and community distress associated with the Deepwater Horizon oil spill","author":"Finucane M. 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