In the shadow of the Chrysler building, amid the crowds and heightened police presence outside Grand Central Terminal, Keith Rutsky lit up a cigarette last week and took a long drag.

"When 9/11 happened, I was smoking less than a pack a day," said Rutsky, 25, a human resources manager. "Now, I'm up to a full pack or two. "It's hard to describe, but it helps me deal with everything. I come outside and have a cigarette and it clears my head. I don't have to think of anything. In a way, it's soothing." In Forest Hills, Julia Goldberg agreed. "I did begin smoking more after Sept. 11. Not directly after, but more gradually," said Goldberg, 31, an office assistant. "I found myself being very nervous because the images keep replaying in my mind, and a cigarette here and there helps me calm down." A recent study by the New York Academy of Medicine found that many New Yorkers are using more cigarettes and alcohol in the aftermath of Sept. 11. Although symptoms of post-traumatic stress disorder apparently have decreased since the attacks, a survey of 2,700 people in the New York metropolitan area found 25 percent have increased their consumption of cigarettes, alcohol or marijuana, or a combination. Among those who said they are smoking more cigarettes than they used to, the proportion is 10 percent, while 18 percent said they are drinking more. About 3 percent said they turned to smoking marijuana more. Researchers see the preliminary figures as a sign that many New Yorkers are relying on addictive substances to offset their heightened stress and anxiety. "We expected that smoking and alcohol use would have decreased [along] with post-traumatic stress," said Dr. Sandro Galea, an epidemiologist with the medical academy. "But that doesn't seem to be the case. There is a public health concern that people are using these substances as a coping mechanism. And there is a worry that people will continue using and become more dependent on cigarettes and alcohol to survive." Because participants in the study were surveyed before the city raised the cigarette tax, researchers said it is unclear whether smoking will continue to rise. In July, Mayor Michael Bloomberg raised the cigarette tax to $1.50 per pack, driving the price to as much as $7.50. Last month, the city Department of Finance reported that cigarette sales in the city had dropped almost 50 percent since the tax became effective. Still, Galea said the fact that as many as 601,000 people - extrapolated from the survey's sample - smoked more nine months after the attack is troubling. A separate study by the Fire Department found that 29 percent of firefighters who smoke are smoking more, and 23 percent of former smokers have started again. Dr. Kerry Kelly, the department's chief medical officer, said the department was so disturbed by those numbers it started a new 18-week smoking cessation program. About 300 firefighters have signed up. "We can't change the toxic exposures that our firefighters may have been exposed to," said Kelly, "but we can try and reduce other exposures like smoking." Kelly said those involved in the recovery effort at the World Trade Center site may even have been plied with free tobacco products. "We have heard that there were people handing out boxes of cigarettes to the firefighters and rescue workers who were at Ground Zero," he said. "They took advantage of people in a vulnerable situation. We wanted to combat that exposure." Although several smokers told Newsday they were smoking and drinking more in the face of heightened stress, others expressed skepticism with the study and said they had cut down on smoking in response to the cigarette tax. Anthony Naccarato lost a family member in the World Trade Center catastrophe and said cigarettes have helped him cope. "I lost a cousin so I've been smoking a lot more," said Naccarato, 24, of Brooklyn. "But I go out of state to get cigarettes because of the [tax] hike." Jennifer Cheng, 20, of Flushing, said her smoking increased after Sept. 11, but then decreased with time. "I did smoke more for a short period right after 9/11, but I'm back to half-a-pack a day instead of a whole pack," Cheng said. "I guess it was my way of dealing with the events."

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