Smokeless Tobacco use Related to Military Deployment, Cigarettes and Mental Health Symptoms in a Large, Prospective Cohort Study Among US Service Members

Abstract

To characterize smokeless tobacco initiation and persistence in relation to deployment, combat, occupation smoking and mental health symptoms. Design Prospective cohort, utilizing self-reported survey data from the Millennium Cohort Study. Setting US military service members in all branches including active duty, reserve and National Guard. Participants Population-based sample of 45 272 participants completing both baseline (July 2001 - June 2003; n = 77 047) and follow-up (June 2004-January 2006; n = 55 021) questionnaires (follow-up response rate = 71.4%). Measurements Self-reported smokeless tobacco initiation and persistence. Findings Over the study period, 72.4% did not deploy, 13.7% deployed without combat exposures and 13.9% deployed with combat exposures while 1.9% were smokeless tobacco initiators and 8.9% were persistent users. The odds of initiation were greater for deployers with combat exposure [odds ratio (OR), 1.76; 95% confidence interval (CI), 1.49-2.09], deployers without combat exposure (OR, 1.31; 95% CI, 1.07-1.60) and those who deployed multiple times (OR, 1.67; 95% CI 1.31-2.14), as well as in smoking recidivists/initiators (OR, 4.65; 95% CI, 3.82-5.66) and those reporting posttraumatic stress disorder symptoms (OR, 1.54; CI, 1.15-2.07). A similar pattern for higher odds of persistent use was observed for deployment and combat exposure, but not for smoking and mental health symptoms. Military occupation was not significantly associated with initiation or persistence. Conclusions Deployment and combat exposure in the US military are associated with increased risk of smokeless tobacco initiation and persistence while smoking and symptoms of post-traumatic stress disorder increase the odds for initiation. Research is needed on aspects of military service amenable to the reduction or prevention of tobacco consumption.

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Document Details

Document Type
Technical Report
Publication Date
Jan 01, 2011
Accession Number
ADA557252

Entities

People

  • Besa Smith
  • Edward J. Boyko
  • Eric D. Hermes
  • Gary G. Gackstetter
  • Shannon C. Miller
  • Timothy. S. Wells
  • Tyler C. Smith

Organizations

  • Yale University

Tags

DTIC Thesaurus Topics

  • Anxiety Disorders
  • Brain Injuries
  • Depression
  • Diseases And Disorders
  • Education
  • Health
  • Health Care
  • Health Services
  • Medical Personnel
  • Mental Disorders
  • Mental Health
  • Military Personnel
  • National Guard
  • Psychiatry
  • Traumatic Stress Disorder
  • United States
  • Warfare

Fields of Study

  • Medicine
  • Psychology

Readers

  • Gulf War Illness and Chronic Multisymptom Illness in Veterans.
  • Military Mobilization and Reserve Forces Studies.
  • Psychological Intervention/Treatment for Stress, Anxiety, PTSD, and Related Emotional and Cognitive Health Symptoms.