When, How, Where Tobacco Initiation and Relapse Occur During U.S. Air Force Technical Training (original) (raw)
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Predicting cigarette initiation and reinitiation among active duty United States Air Force recruits
Substance Abuse, 2019
Background-The first year of military service in the United States Air Force (USAF) is a high risk time for tobacco use. Previous studies have demonstrated the effectiveness of a tobacco ban during Basic Military Training. However, no studies have examined the effect of increasing the protracted ban for an additional four weeks. Understanding the patterns of initiation and reinitiation following the protracted ban will inform future intervention and policy efforts. Methods-The current study examines patterns of cigarette smoking among a sample of 2,188 USAF personnel at baseline and after their first year of service. Results-One year after BMT, we observed that 65.0% of USAF enlistees who never used cigarettes prior to BMT remained abstinent, 9.6% of individuals who formerly used remained abstinent from cigarettes, 9.3% who never used prior to BMT initiated cigarette smoking, and 16.1% who used prior to BMT reinitiated cigarette smoking. Despite the extended tobacco ban in BMT and Technical Training, 12.6% of individual who never smoked initiated cigarette smoking and 62.6% of individuals who formerly smoked reinitiated. Over half (54.2%) of Airmen who reported smoking cigarettes at follow-up, reported initiating or re-initiating during Technical Training. Conclusions-Our findings indicate that while the increased ban prevents additional individuals who smoked cigarettes prior to joining the Air Force from re-initiating, it has no effect on initiation among individuals who report never using prior to military service. Additional research is needed to understand what may be leading to these high rates of initiation and re-initiation in Technical Training following the ban.
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2015
Although there is increasing attention to the prevalence of new and emerging tobacco products in the civilian population, remarkably little is known about the current prevalence of these products in a military population. The current investigation was designed to determine the prevalence of tobacco and nicotine containing products (TNCP) and correlates of use across multiple cohorts of trainees undergoing Technical Training in the US Air Force between April 2013 and December 2014. Chi-square test, Cochran-Armitage test for linear trend, and logistic regression models were applied to test differences and linear trends across time for TNCP use as well as correlates of use in a cross-sectional sample of 13,685 Airmen (final analytic sample). Over a quarter (26.9%) of Airmen reported regular use of a TNCP. The two most prevalent products were cigarettes (11.2%) and hookah (10.5%). Among correlates of use, Airmen that regularly use TNCPs were more likely to be male, younger, non-Hispanic...
Contemporary Clinical Trials, 2014
Smoking cessation is a primary method of reducing excess mortality and morbidity. Unfortunately, the vast majority of cessation attempts end in eventual relapse. Relapse-prevention interventions have shown some success at improving the long-term maintenance of tobacco abstinence among individuals motivated to abstain. However, involuntary tobacco abstinence (e.g., military training, hospitalization, incarceration) presents another opportunity for intervention to prevent relapse. During basic military training (BMT), tobacco use is strictly forbidden in all service branches, but tobacco relapse (and initiation) following BMT is extremely high. This paper reports on the design, intervention development, and baseline characteristics of a randomized controlled trial testing minimal interventions designed to prevent tobacco relapse among United States Air Force (USAF) personnel following BMT. Participants are randomized by squadron to receive either a standard smoking-cessation booklet, a new motivation-based booklet designed specifically for USAF personal, or the latter booklet combined with a brief, face-to-face motivational session. Primary outcomes will be self-reported tobacco use at 12 and 24 month follow-up. Given that the Department of Defense is the world's largest employer, the potential of leveraging involuntary tobacco abstinence during BMT into extended abstinence has substantial public health significance.
Deployment and Smokeless Tobacco Use Among Active Duty Service Members in the U.S. Military
Military medicine, 2018
The prevalence of smokeless tobacco use among U.S. active duty service members has been much higher than in the U.S. general population. The association between deployment and smokeless tobacco use has not been well studied. We investigated the association between deployment and smokeless tobacco use among U.S. active duty service members. We also evaluated the modification effects from other factors related to smokeless tobacco use on the deployment-smokeless tobacco use association. Eligible active duty service members stationed at two military installations (Fort Bragg, NC, USA and Lackland Air Force Base, TX, USA) were recruited from July 2015 to May 2016. Each participant completed a self-administered questionnaire. Multivariable logistic regression was used to assess the association between deployment and smokeless tobacco use and estimated odds ratio (OR) and 95% confidence interval (CI). Stratified analysis was performed to evaluate modification effects from other commonly k...
Tobacco Use in the Army: Illuminating Patterns, Practices, and Options for Treatment
Military Medicine, 2009
Tobacco use by soldiers has been prevalent throughout the 20th century. Tobacco has been seen as a "right."' Additionally, tobacco was viewed as a boost to a soldier's morale and to provide comfort, while reducing stress in austere conditions. Today, tobacco is known to increase healthcare costs, adversely affect readiness,^ and impact the military members' physical performance.^ The purpose of this ethnographic study was to describe patterns, practices, and experiences of active duty Army soldiers who use tobacco, have quit using tobacco, and have relapsed after a period of tobacco abstinence. Five themes were uncovered; 1.) Experiences associated with use of tobacco, 2.) Tobacco use in the Army, 3.) Experiences of starting and restarting tobacco, 4.) Balancing health risks with tobacco use, and 5.) Tobacco use regulations and policies. Findings are consistent with the conclusion that the Army culture supports soldiers' tobacco use.
The Prevalence of E-cigarette Use in a Sample of U.S. Air Force Recruits
American Journal of Preventive Medicine, 2015
Introduction-The prevalence of electronic cigarette (e-cigarette) use is increasing markedly in the general population. Yet, remarkably little research exists to examine these ongoing trends in at-risk populations, and nothing is known about the prevalence of e-cigarette use among military personnel. The purpose of the current study is to provide recent (2013-2014) data on the prevalence of regular e-cigarette use in a population of recruits prior to their entry into the U.S. military. Methods-The study utilized a cross-sectional assessment of e-cigarette and other tobacco and nicotine-containing product (TNCP) use in 2013-2014 among 10,043 U.S. Air Force (USAF) recruits in Technical Training. Chi-square tests, the Cochran-Armitage test for trend, and logistic regression models tested differences and trends across time for e-cigarette use. Results-The rate of e-cigarette use among recruits was 5.2%, which doubled (3% to 6.5%, p<0.0001) across a 1-year period. E-cigarette use was associated with increased odds of all measured TNCPs, as well as dual and poly use (all p<0.0001). Conclusions-Rates of e-cigarette use are slightly higher in young USAF recruits than in the general population, and e-cigarette users are likely to be using other TNCPs in tandem. Although additional work is needed to understand the reasons for this concomitant use, this is a necessary first step to understanding e-cigarette use prevalence in military populations. Historic trends suggest that, like general populations, e-cigarette use is on the rise for those entering the USAF and should be monitored to inform future prevention programming.
Tobacco Use During Military Deployment
Nicotine & Tobacco Research, 2013
introduction: Tobacco use among military personnel is associated with significant health care expenditures, lost productivity, and compromised combat readiness. The prevalence remains high among military personnel and may increase in high-risk situations such as deployment. We assessed the prevalence of tobacco use across the deployment cycle, changes in tobacco use (nonuse, continued use, initiation/harm escalation, cessation/harm reduction) during deployment, and the impact of deployment history on tobacco use.
Adverse Effects of Tobacco Use in Deployed Military Units
KVÜÕA toimetised, 2010
Although research reveals that smoking prevalence has in general stabilized or is even decreasing among military personnel, this trend does not ultimately apply. Being young, being deployed, or being a member of Army personnel, for instance, is proven to increase the risk of being or beginning to be a tobacco user. There are not immediate observable links between tobacco habits and the serious health-related consequences found during the service period because of the long time lag between tobacco use and its consequences. Also the impact of smoking on military performance can be defined rather more indirectly than directly. However, findings in the Estonian military sample (n=135) indicate that an increase in smoking behaviour while on deployment not only corresponds with poorer psychological wellbeing and general health, but also with being forced to stay away from duty because of physical aches. These results can be taken as indicators that smoking behaviour decreases fitness for military operations and should be targeted by performance enhancement activities. The role of the military culture of smoking behaviour and the arguments for an effective strategy for tobacco use cessation among military personnel are discussed.
The association of smoking and the cost of military training
Tobacco Control, 2001
Objective-To determine if premature discharge from the US Air Force was associated with the smoking status of recruits. Design and setting-A total of 29 044 US Air Force personnel recruited from August 1995 to August 1996 were administered baseline behavioural risk assessment surveys during basic military training. They were tracked over a 12 month period to determine those who were prematurely discharged. Main outcome measures-Excess training costs as a result of premature discharge. Results-In this 12 month period, 14.0% of those entering the US Air Force were discharged at a one year follow up. In both univariate and multivariate models, the best single predictor of early discharge was smoking status. Overall, 11.8% of non-smokers versus 19.4% of smokers were prematurely discharged (relative risk 1.795). Conclusions-Using US Department of Defense data on the cost of military training, recruits who smoke in the US Air Force are associated with 18millionperyearinexcesstrainingcosts.Appliedtoallservicebranches,smokingstatus,whichrepresentsaconstellationofunderlyingbehavioursandattitudesthatcancontributetoearlydischarge,isassociatedwithover18 million per year in excess training costs. Applied to all service branches, smoking status, which represents a constellation of underlying behaviours and attitudes that can contribute to early discharge, is associated with over 18millionperyearinexcesstrainingcosts.Appliedtoallservicebranches,smokingstatus,whichrepresentsaconstellationofunderlyingbehavioursandattitudesthatcancontributetoearlydischarge,isassociatedwithover130 million per year in excess training costs.
United States Military Tobacco Policy Research: A White Paper
2016
United States Military Tobacco Policy Research: A White Paper Authors: Elizabeth A. Smith, Ph.D., Walker S. Poston, Ph.D., Sara A Jahnke, Ph.D., Nattinee Jitnarin, Ph.D., Christopher K. Haddock, Ph.D., Ruth E. Malone, Ph.D. Contact information: Elizabeth A. Smith, Ph.D. Email: Libby.Smith@ucsf.edu This work was funded by the National Institutes of Health, National Cancer Institute and National Institute on Drug Abuse (CA109153/DA036507 and CA157014/DA036509). The funding agencies played no role in the selection of the research questions, the conduct of the research, or the preparation of the manuscript.