Cigar and pipe smoking in the U.S. military: prevalence, trends, and correlates.

This article examines the prevalence, trends, and correlates in cigar/pipe smoking and their relation to cigarette smoking among active duty U.S. military personnel. An examination of the trends in cigar/pipe smoking was conducted with data from 1985 to 1998, and predictors of smoking were determined for 1998. Rates of cigar/pipe smoking declined from 1985 until about 1992 and then began to increase. From 1995 to 1998, there was a 75% increase in the prevalence of cigar/pipe smoking. Greater prevalence of cigar/pipe smoking was associated with male gender, younger age, relatively favorable beliefs and values toward smoking, and being a current cigarette smoker. Findings indicate a notable increase in past-year cigar/pipe smoking. These findings suggest that military tobacco prevention and early intervention programs would benefit from including components that deal specifically with cigar and pipe use in addition to cigarette smoking.

Using social indicators to estimate county-level substance use intervention and treatment needs.

This study describes the development of a model for estimating county-level substance use intervention and treatment needs using social indicators. Forty-five indicators conceptually related to substance misuse were reduced through factor analysis. Logistic regression models were then developed using selected indicators to predict service needs. The following variables were significant predictors of substance use intervention and treatment needs: the percent of the population who is male aged 15 to 34, urbanicity, and population density. The results suggest that substance misuse may be successfully modeled by a few easy to obtain and reliably measured variables describing the population characteristics of local communities.

Trends in overweight and physical activity among U.S. military personnel, 1995-1998.

BACKGROUND: The purpose of this study was to deter mine whether changes in physical activity patterns account for the increasing prevalence of obesity, utilizing a large, representative sample of male and female U.S. military personnel. METHODS: Data from the 1995 and 1998 waves of the Department of Defense Survey of Health Related Behaviors among Military Personnel were utilized. Overweight was defined as body mass index > or =25. Respondents were classified as physically active if they reported > or =3 days/week of vigorous activity. Three sequential multivariate logistic regression models were analyzed separately for males and females with overweight regressed on year of study (1995 or 1998), demographic characteristics, and physical activity. RESULTS: Some 50% of military personnel in 1995 and 54% in 1998 were classified as overweight, representing a significant increase in overweight over the 3-year period for both males and females. Overweight military personnel were more likely to be male, older, African American or Hispanic, married, and enlisted personnel. Physical activity levels were high, with around 67% of the sample engaging in regular, vigorous physical activity. Although physical activity levels increased among male personnel between 1995 and 1998, there was not an independent association between physical activity and overweight, and changing physical activity patterns did not account for the increase in over weight from 1995 to 1998. CONCLUSIONS: The U.S. military is experiencing a trend toward increasing overweight that mirrors the pattern among the general population. The results of this study suggest that the rise in overweight among the military is not explained by a decrease in physical activity.

Trends in substance use among US military personnel: the impact of changing demographic composition.

This paper examines the impact of the military population's changing demographic composition on observed changes in substance use by military personnel. Cross-sectional data are drawn from the six Department of Defense Worldwide Surveys of Substance Abuse and Health Behaviors Among Military Personnel conducted in 1980, 1982, 1985, 1988, 1992, and 1995. Using the method of direct standardization to adjust for changes in demographic composition, trends in substance use are examined. Changes in heavy alcohol use were more affected by demographic changes in the military population than were changes in illicit drug use or cigarette use. Findings indicate that changes in demographic composition may need to be controlled when assessing trends from cross-sectional surveys.

Psychosocial correlates of nicotine dependence among men and women in the U.S. naval services.

This study assessed the prevalence and psychosocial correlates of clinical criteria-based diagnoses of nicotine dependence in men and women in the U.S. naval services. Analyses were based on data from the 1995 Perceptions of Wellness and Readiness Assessment, a population-based self-report survey of 9,856 active-duty Navy and Marine Corps members worldwide, specifically focusing on a subsample of those who completed the telephone version of the Quick Diagnostic Interview Schedule (n = 782). Twenty-five percent of all telephone interview volunteers met diagnostic criteria for lifetime nicotine dependence, and 15% met criteria for nicotine dependence in the last year. There was no difference in nicotine dependence by job classification (traditional vs. nontraditional) among women. Women who were abused prior to entering the military were almost three times as likely to be nicotine dependent as those not abused. Men who had been exposed to combat or violence were twice as likely to be nicotine dependent as those not exposed.

Stress and substance use among military women and men.

This paper examines the relationship between perceived stress (at work, in family or personal life, and from being a woman in the military) and substance use (heavy drinking, illicit drug use, cigarette smoking) among active-duty military women and men. Data were drawn from over 16,000 respondents to the 1995 Department of Defense Survey of Health Related Behaviors Among Military Personnel. Findings indicated substantial substance use and perceived high stress in the armed forces. Further, the relation between substance use and stress varied by gender. Military women reported substantially lower rates of heavy drinking than men, but had similar rates of illicit drug use and cigarette smoking. Both military women and men were more likely to describe their military duties as more stressful than their family or personal lives; for women, the stress associated with being a woman in the military was second to stress at work. Stress at work or in the family was an important predictor of substance use among military men, but not among military women. For military women, stress associated with being a woman in the military was predictive of illicit drug use and cigarette use. These findings suggest that more effective stress management strategies may need to be implemented for military men to reduce the link between stress and heavy alcohol use, illicit drug use, and smoking.

Cigarette smoking in the U.S. military: findings from the 1992 Worldwide Survey.

BACKGROUND: Using data from the military's Worldwide Survey series, this article presents findings on the prevalence of smoking among active-duty military personnel in 1992 and trends since 1980. METHODS: A stratified probability sampling design was used in the 1992 Worldwide Survey. Military installations worldwide were sampled, and then active-duty personnel within these installations were selected. A total of 16,395 usable questionnaires were obtained, for an overall response rate of 77.3%. RESULTS: The prevalence of cigarette smoking among military personnel has declined from 51% in 1980 to 35% in 1992. This decline was not explained by changes in the sociodemographic composition of the military population. Overall, smoking was more prevalent among personnel who were white, had less education, and were enlisted. In addition, enlisted men reporting higher levels of work-related stress were more likely to be smokers. Over half of all military personnel who were smokers in the past year attempted to quit. CONCLUSIONS: The military has made considerable progress since 1980 in reducing the prevalence of smoking among military personnel. Nonetheless, the prevalence in 1992 was still relatively high, affecting about one of every three personnel. A promising group to target in future antismoking efforts may be smokers who tried to quit during the past year.

Standardized comparisons of the use of alcohol, drugs, and cigarettes among military personnel and civilians.

BACKGROUND: Understanding the effectiveness of policies and programs aimed at combating substance abuse in the military requires comparison with the civilian population from which military personnel are drawn. METHODS: Standardized comparisons of the use of alcohol, drugs, and cigarettes among military personnel and civilians were conducted with data from the 1985 Worldwide Survey of Alcohol and Nonmedical Drug Use among Military Personnel and the 1985 National Household Survey on Drug Abuse. The two data sets were equated for age and geographic location of respondents, and civilian substance use rates were standardized to reflect the sociodemographic distribution of the military. RESULTS: Military personnel were significantly less likely than civilians to use drugs, but were significantly more likely to use alcohol and cigarettes and to engage in heavy use of alcohol and cigarettes. Heavy drinking was especially likely among young military men. Military women were similar to military men in their smoking and drug use patterns. CONCLUSIONS: Findings suggest that military policies and programs have been notably effective in reducing drug use, but that efforts to limit alcohol and cigarette use should be intensified. Military efforts directed against alcohol abuse should be targeted toward younger men, while smoking and drug prevention programs should be directed toward both men and women.

Smoking and tobacco use by U.S. military personnel.

Findings regarding smoking behavior for the 1985 survey of military personnel were compared to findings from earlier surveys. A decline in the percentage of cigarette smokers was evident for all ranks and ages. Reported use of smokeless tobacco and cigar/pipe smoking indicated that one-fifth of the cigarette smokers also use smokeless tobacco and that two-fifths of the cigarette users smoke a pipe or cigar. Among non-smokers of cigarettes, about one-tenth of the respondents used smokeless tobacco and/or smoked a pipe or cigars. Using self-evaluation of health status, non-smokers reported "excellent" health significantly more than smokers.

Prevalence, trends, and correlates of alcohol use, nonmedical drug use, and tobacco use among U.S. military personnel.

This paper presents data on substance use by military personnel from a series of worldwide surveys conducted in 1985, 1982, and 1980 with primary emphasis on the 1985 survey. Estimates are based on responses from participants serving on active duty in the Army, Navy, Marine Corps, and Air Force. Results for 1985 indicate pervasive use of alcohol, substantial use of tobacco, and low nonmedical use of drugs among military personnel. Average daily consumption of alcohol declined significantly from 1.4 ounces in 1982 to 1.2 ounces in 1985, but the patterns of use remained relatively constant. Nonmedical drug use during the past 30 days declined significantly, from 27.0% in 1980, to 19.0% in 1982, to 8.9% in 1985. Cigarette smoking declined significantly from 51.4% in 1982 to 46.2% in 1985. Current alcohol and drug use is concentrated among younger, less educated, unmarried, and junior and mid-career enlisted personnel. Cigarette pack years are higher among males, whites, those with less than a high school education, and senior enlisted personnel. Results show progress in reducing drug use and smoking in the military, but little change in patterns of alcohol use. New initiatives and approaches by the military to further reduce substance abuse are discussed.

Substance use and health among U.S. military personnel: findings from the 1985 Worldwide Survey.

The relationship between substance use (alcohol, drugs, and tobacco) and health (health practices, number of illnesses, number of physician visits, and days hospitalized) was examined using data from the 1985 Worldwide Survey of Alcohol and Nonmedical Drug Use Among Military Personnel. Substance users, particularly heavy users, were less likely than nonusers to engage in health practices and were more likely to experience illness, physician visits, and hospitalizations. Significant effects on the number of illnesses were observed for heavy drinkers compared with abstainers, drug users other than marijuana only users compared with nonusers, and those who smoked one or more packs of cigarettes per day compared with nonsmokers. The potential of substance use programs in improving health status and health promotion programs in reducing substance use among military personnel is discussed.

Patterns of alcohol and drug abuse in drug treatment clients from different ethnic backgrounds.

In this paper we have sought to identify differences in alcohol consumption patterns and problems among young adult males from white, black, and Hispanic ethnic groups entering drug treatment programs. In overall consumption patterns we found results similar to those obtained in general population studies. However, about one-third of the clients in all ethnic groups could be classified as heavier drinkers (drinking at least once a week and 4 or more drinks per drinking occasion) in the period immediately prior to treatment. About one-fourth of the clients in each ethnic group consumed a daily average of 2.5 ounces of absolute alcohol. Compared with the other ethnic groups, blacks were the most likely to be abstainers and reported regular alcohol use and drunkenness at later ages. Regardless of the pattern of development, similar proportions of the clients in all ethnic groups reported heavier drinking levels by age 21-30. Consistent with the current hypotheses in the literature, whites reported much higher levels of alcohol-related problems and prior treatment. Despite having similar levels of drinking, black and Hispanic ethnic groups did not appear to recognize alcohol as a problem or to report alcohol-related problems to the extent that whites did. Examination of drug-use patterns showed great variation in the nature and extent of drug use among the three ethnic groups. Whites were distributed among the seven patterns of use. Heroin use with cocaine, marijuana, and alcohol was the predominant pattern for blacks and Hispanics. Although the patterns of drug use differed greatly, these patterns were not differentially related to alcohol consumption or alcohol-related problems within ethnic groups. On the contrary, the drug-use patterns appeared to be a stronger predictor than ethnicity of use and problems. Multiple-nonnarcotic-users reported the highest levels of alcohol consumption and the greatest numbers of alcohol-related problems. This group typically reported the highest number of alcohol-related problems. Expression of a current need for treatment and a history of prior alcohol treatment were highest for black multiple-nonnarcotic-users. Our examination of the influences of family and friends was based on a limited number of questions available in the data. Heavier drinking was reported by clients who lived with friends, had family or friends who drank regularly, or had extensive involvement in the drug-use network, including drug sales. No ethnic differences were found.(ABSTRACT TRUNCATED AT 400 WORDS)