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Objectives. We investigated the consequences of exposure to acts of terrorism among Israeli adolescents. We examined whether exposure to terrorism predicted adolescents' use of cigarettes, alcohol (including binge drinking), and cannabis after we controlled for posttraumatic stress and depressive symptoms and background variables. Methods. Anonymous self-administered questionnaires were given to a random sample of 960 10th and 11th grade students (51.6% boys, 48.4% girls) in a large city in northern Israel. Results. Close physical exposure to acts of terrorism predicted higher levels of alcohol consumption (including binge drinking among drinkers) and cannabis use. These relationships remained even after we controlled for posttraumatic stress and depressive symptoms. Conclusions. In addition to posttraumatic stress symptoms, negative consequences of terrorism exposure among adolescents included substance abuse. The similarity between our findings among Israeli adolescents and previous findings among US adults suggests cross-cultural generalizability. Given the risks for later problems from early-onset substance abuse, the consequences of terrorism exposure among adolescents merit greater research and clinical attention. (Am J Public Health. 2007;97:1852-1858. doi:10.2105/AJPH.2006.090514) [ABSTRACT FROM AUTHOR]