Smokeless tobacco use in military personnel

Military personnel are more than twice as likely as civilians to use smokeless tobacco (ST), and recent studies indicate that military prevalence rates are rising. However, few studies have examined factors related to ST use in the military. The present study evaluated the characteristics of ST use in 785 active duty military personnel. The results indicated that the average age of initiation was 17.7 years, participants had used ST for 12.3 years, and they used approximately four tins or pouches of tobacco per week. Army personnel were more likely than Air Force personnel to be older, to have used ST longer, and to be heavier users. Officers had used ST longer than enlisted personnel and were more likely to have had a recent quit attempt. Enlisted personnel were more than three times as likely to report concurrent cigarette smoking. These results indicate that there are significant differences in ST use patterns in military personnel, and cessation programs should be tailored to meet these differences.     

Incarceration and veterans of the first Gulf War

OBJECTIVE: This study investigated the prevalence of incarceration and the association with deployment among veterans of the first Persian Gulf War (GW). METHODS: A structured telephone interview of military personnel from Iowa deployed to the Persian Gulf and a comparison sample of nondeployed military personnel was conducted. The interview consisted of validated questions, validated instruments, and investigator-derived questions to assess relevant medical and psychiatric conditions. A total of 4,886 subjects were randomly drawn from one of four study domains, i.e., GW regular military, GW National Guard/Reserve, non-GW regular military, or non-GW National Guard/Reserve. Symptoms of medical conditions, psychiatric disorders, and health care utilization were the main outcome measures. RESULTS: Nearly one-quarter (845 of 3,695 subjects, 22.9%) had been incarcerated at some point before the interview ("ever incarcerated"). Ever incarcerated veterans had a higher frequency of psychiatric and medical comorbidity and higher rates of health care utilization. Ever incarcerated status was associated with male gender, enlisted rank, lower educational levels, low levels of military preparedness, discharge from service, cigarette smoking, antisocial traits, court martial and/or other military discipline, having seen a mental health professional, and having used illegal drugs. GW veterans who participated in combat had a modestly higher risk for incarceration after the GW than did noncombatants (odds ratio, 1.6; 95% confidence interval, 1.0-2.5). CONCLUSIONS: Military recruits with a history of incarceration more often displayed problematic behaviors, more often developed psychiatric/medical conditions, and had high rates of health care utilization. A history of incarceration may be a behavioral marker for substance abuse, antisocial behavior, and mental illness. Importantly, GW deployment carried no increased risk of subsequent incarceration overall.     

Documentation of activity and rest of a U.S. National Guard attack helicopter battalion.

A. U.S. National Guard attack helicopter battalion was monitored in order to document the activity and rest obtained during the annual training exercises. A total of 39 soldiers wore wrist activity monitors during the 2-week training period. The data from these monitors discriminate activity from rest. Results indicated the following: 1) at some point during the exercises, everyone became sleep deprived; 2) the participants who received the most rest of the group were the enlisted headquarters personnel and the pilots; 3) the soldiers who received the least amount of sleep were the commander of the battalion and the maintenance personnel. Some recommendations are offered for future planning of National Guard training exercises.     

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.     

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.     

Health-related behaviors in young military smokers

This cross-sectional study examined the association between smoking and other health-related risk behaviors, individually as well as in clusters, across branches of military service in the higher risk ages of 18 to 25 years old within the 1998 Department of Defense Survey of Health-Related Behaviors among Military Personnel. Examination of the demographic variables revealed that, in general, smokers tended to be single, white, enlisted men in the 18- to 20-year age group with less education and serving in the Army or Marine Corps. Our findings support that there is an increased likelihood of co-occurrence of substance use along with other negative health-related risk behaviors found in military members. It may be practical and necessary to develop a focused survey given to those attending smoking cessation interventions, or perhaps to smokers in general, which attempts to identify associated risk behaviors and channel clients accordingly.     

Smoking cessation therapy and the return of aviators to flying duty

Smoking cessation is an important part of every primary care physician's work. The importance of smoking cessation in the reduction of cardiovascular morbidity and mortality and the reduction of cancer incidence cannot be overstated. Various treatments have been established to encourage smoking cessation; these include group and individual psychological therapy, nicotine replacement in various forms, and drug therapy. The best-known drug used for smoking cessation is bupropion SR (Zyban). Smoking in aviators is not different than in the general population in terms of prevalence. Thus it is important for flight surgeons worldwide to be familiar with the magnitude of the problem and the available treatment options. Yet, it is also important for this community to become familiar with the relevance of this treatment to aviation and to recognize the limitations pertinent to flying personnel who are attempting to quit smoking. We present treatment options for smoking cessations and their limitations on flying personnel.     

Seven steps of gradual cessation of smoking--an example from India

BACKGROUND/AIM: [corrected] One sixth of smokers in the world live in India. The National Family Health Survey showed that individuals with no education were 2.69 times more likely to smoke and chew tobacco than those with postgraduate education. Whether the physicians' interaction with public can cause the smoking cessation or habit by detailing the harmful effects as well as benefits of cessation without any withdrawal effects? Our aim was, therefore, to help people to stop smoking step by step. METHODS: The study was conducted at the University Student Health Care Centre, Banaras Hindu University, Varanasi, India, from June 2004 to February 2005. A total of 1,200 students smokers (graduate, post graduate or research scholars) participated. They were from 17 to 32 years old (mean age, 26 years). All were male sex. Each and every student was explained in details risks and hazards, and benefits of cessation, focusing this latter on immediate and substantial benefits at any sex and age; their every question and quarries were explained. All were told that either they should stop smoking immediately or minimized step by step. The seven steps were explained to them. RESULTS: The smoking duration was one year and more in all the participants ranging from one to 15 years; the average period of smoking was five years and six months; the number of smoked cigarettes per day was 12 on average (5-20). In 450/1200 (37.50%) students, either of any family members were smoking while 200 (16.66%) students have been inspired from their friends. The majority of 780/1200 (65%) gave-up smoking at any step as advised. The followup could not be done in 80/1200 (6.6%) students who did not report at any of the stages. Finally, 340/1200 (28.0%) students either reduced the number or failed to give-up smoking. CONCLUSION: The results of the study are very encouraging. Such interaction type of doctors with smokers will not only help to the concerned person but also to the society.     

Carpal tunnel syndrome: effect on Army dental personnel

The purpose of this study was 2-fold: (1) to determine the prevalence of hand problems, in particular carpal tunnel syndrome (CTS), among Army dental personnel; and (2) to identify dental professionals at risk. A 12-page survey was mailed to all U.S. Army military and civilian dental personnel. Of the 6,320 surveys mailed, 80.9% were returned completed. An analysis was performed identifying the prevalence of hand problems and CTS and noting differences between civilian and military dental personnel. Of the 5,115 surveys analyzed, 44.8% indicated hand problems and 25.4% were determined to indicate a high probability of CTS. Of the 18 dental job specialties, dental therapy assistants and dental hygienists had the highest prevalence of CTS, 73% and 57%, respectively. Army dental personnel are at greater risk of developing CTS than the general public, especially civilian dental personnel, who were female, older, and employed longer.     

Hypercholesterolemia and smoking habits of Lithuanian military personnel

OBJECTIVE: To investigate the prevalence of risk factors for cardiovascular disease, namely, hypercholesterolemia and current smoking, among 25- to 54-year-old men and women among Lithuanian active duty military personnel. METHODS: Serum cholesterol levels were measured enzymatically for 200 persons (126 men and 74 women). Interviews regarding smoking habits were performed for 82.5% of those persons (98 men and 67 women). RESULTS: Hypercholesterolemia (total cholesterol level of > or = 6.2 mmol/L) was determined for 45.2% of men and 40.5% of women. After distribution of men and women into three age groups (25-34, 35-44, and 45-54 years), it was determined that the rate of hypercholesterolemia increased with age (among groups of men, 29.6%, 46.7%, and 74.0%; among groups of women, 18.8%, 51.5%, and 40.0%, respectively). The proportion of current smokers among men was 2.6 times higher than that among women (45.9% vs. 17.9%; p < 0.001). The highest rate of current smoking was in the 35- to 44-year group of men (64.5%). The coexistence of hypercholesterolemia and current smoking among men was 3.1 times higher than that among women (23.5% vs. 7.5%; p < 0.01). The highest rates of current smoking with hypercholesterolemia were in the 35- to 44-year and 45- to 54-year groups of men (32.2% and 31.8%, respectively). CONCLUSION: The data demonstrated a relatively high rate (32.1%) of coexistence of two independent risk factors for cardiovascular disease (hypercholesterolemia and current smoking) among men 35 to 54 years of age from Lithuanian military personnel.     

Smoking-related attitudes, characteristics, and opinions in a group of young men with asthma.

The objective of this study was to examine the attitudes, characteristics, and opinions about smoking of a group of young asthmatic men. POPULATION AND METHODS: An anonymous, personal questionnaire was administered to 611 young male volunteers who had been diagnosed with asthma (according to the National Heart, Lung, and Blood Institute/World Health Organization Global Initiative for Asthma, 1995) in the respiratory disease and allergy clinics of the Burgos Military Hospital (Spain). This questionnaire contained items related to personal information, asthma characteristics, opinions about smoking, and information related to smoking habits. RESULTS: Six hundred patients with asthma completed the questionnaire. All were men, mean age 20.16 +/- 3.03 years; 189 (31.5%) were smokers and 16 (2.5%) were ex-smokers. Mean age at onset of regular smoking was 16.46 +/- 2 years. Sixty-five percent (65.07%) smoked fewer than 10 cigarettes per day. Most of the smoking asthmatics had mild asthma (58.9%). Eighty-eight percent (88.3%) had moderate dependence. Many of the smoking asthmatics were contemplating stopping smoking (54%), and 59% had tried before to stop. Concern about health was the main reason given for stopping smoking. Asthmatics who smoked had a higher percentage of smokers among family members, friends, and colleagues than nonsmoking asthmatics. Attitudes toward smoking were more permissive among smoking asthmatics. Only 36.64% of the total had received information about tobacco previously. In the sample group, 7% claimed that they did not smoke but their carbon monoxide concentration in exhaled air was 10 ppm or higher. CONCLUSIONS: There were no differences in the onset of the smoking habit between asthmatic and nonasthmatic young people. A large percentage of the smoking asthmatics were considering smoking cessation, motivated mainly by their asthma condition. The group as a whole had little previous information about tobacco.     

海警海上医疗伴随保障常见病研究

目的 统计海警出海任务常见疾病,为执行医疗伴随保障任务提供依据.方法 通过访谈调研、医疗保障日志梳理,对海警海上医疗保障情况进行分析,统计其高发疾病谱,并提出建议.结果 高发疾病种类为:上呼吸道感染(44.71％)、运动伤(15.87％)、过敏(5.77％)、咽炎(3.85％)、癣(3.85％),应针对高发病种和特殊环...     

Side effects from influenza vaccination: differences between returned and random surveys

Annually vaccinated Air National Guard members were surveyed by return of questionnaire in 1991 (20.5%) and in 1992 by random phone survey (23.5%). By returned questionnaire the sample reported any side effects at the rate of 48.1%; by randomly telephoned sample a significantly lower rate, 37.7% (p < 0.02), was reported. An inverse relationship existed between age and return of the questionnaire, present only in males, despite an increased rate of reporting of side effects in the younger ages. Females reported a significantly higher rate of side effects than males by return of questionnaire in all age groups and for the sample as a whole (p < 0.03). In the randomized survey the age effect disappeared, except for the tendency for the oldest group to report fewer side effects than the other age groups in their aggregate (p < 0.07). The higher reporting rate for females was less apparent by random survey but remained as a trend (p = 0.08; odds ratio 1.398; 95% confidence interval = 0.776-4.049).     

Snuff use and smoking in Finnish olympic athletes

This study aimed to assess the prevalence of smoking and snuff use in Finnish elite athletes. Of all the athletes (n = 494) financially supported by the National Olympic Committee, 446 completed a structured questionnaire (response rate 90.3 %) in 2002. A control group (n = 1504, response rate 80.2 %) comprised an age-matched sample from the population-based sample collected by the National Public Health Institute. Any smoking was reported by 11.4 % of the athletes (3.6 % daily and 7.8 % occasionally) and by 38.3 % of the controls (28.1 % and 10.2 %). After adjusting for age, sex, and education, OR (95 % CI) for any smoking was highest 0.42 (0.23 - 0.77) for athletes in skill-based events and lowest 0.06 (0.02 - 0.17) for endurance athletes as compared with controls. Snuff use was reported by 24.6 % of the athletes (9.6 % daily and 15.0 % occasionally) and by 3.7 % of the controls (1.8 % and 1.9 %). The adjusted OR (95 % CI) for any snuff use was highest 15.6 (9.55 - 25.6) for team-sport athletes and lowest 3.33 (1.54 - 7.21) for endurance athletes as compared with controls. Although snuff use in the general female population is rare, also female athletes did use snuff. Though prevalence of daily smoking among athletes was one-seventh of the respective figure for the general population, prevalence of daily snuff use was five-fold that of controls. Tobacco free elite athletes are valuable in health counselling because athletes are considered role models influencing their peers and the sport. Sport associations are challenged to ban all forms of tobacco.     

Predictors of psychiatric hospitalization in the Navy

Mental disorders represent an important source of morbidity among U.S. military personnel and are a common reason for early separation from the military. The objective of this study was to identify factors predictive of hospitalization for mental health disorders in a large sample of enlisted Navy personnel. Demographic variables and a variety of psychosocial variables assessed on the Sailors' Health Inventory Program questionnaire were studied as predictors of psychiatric hospitalization. Three psychiatric categories were examined: adjustment reaction, personality disorder, and all other mental health disorders. Several variables were significantly predictive of all three categories of psychiatric hospitalization: female gender, low education level, history of abuse (physical, emotional, or sexual), and tobacco smoking. The results of this study support efforts to develop better psychological screening methods and potential interventions aimed at helping recruits adapt to military life.     

Prevalence of smoking among Israeli male athletes.

A survey of smoking habits was carried out on 2447 males age 14-40 years. The subjects were athletes trained in a wide variety of sports. Overall 15.5% of the athlete population were smokers. When broken down into training groups, the highest smoking prevalence was reported by subjects not engaged in specific training, while the lowest prevalence was reported by endurance trained athletes. When divided into specific sports, the highest percent of group smoking was found in soccer players. Smoking prevalence increased with increasing age. No significant differences in smoking prevalence existed between groups of varying ethnic origin. This study provides data on groups of athletes to target in smoking intervention programs.     

Flight crews with upper respiratory tract infections: epidemiology and failure to seek aeromedical attention

A voluntary questionnaire was used to determine the epidemiology of upper respiratory infections (URI), and whether aeromedical attention was sought. Questionnaires completed by 256 of 276 eligible flight crewmembers revealed that over half, 61.7% (158), reported having greater than or equal to 1 URI during a 6-month period, for a total of 272 URIs. No statistically significant associations, p greater than 0.05, were noted between the occurrence of URI and sex, age, pilot vs. enlisted, or smoking status. Subjects with children living at home with them were more likely to report having URIs than those with no children, p less than 0.10. Aeromedical attention was not sought in 55.5% (151/272) of the URI episodes. An Aeromedical Concern (AMC) was determined to occur in 69.5% (105/151) of these representing 38.6% (105/272) of all URIs. The most common reason for AMC was taking self-prescribed medications. AMCs were more frequent among enlisted personnel than officers (pilots), p less than 0.05. Possible reasons why AMCs may occur are discussed. In summary, URIs are common in aircrews, as is the failure to seek aeromedical attention.     

Contraceptive use and attitudes toward family planning in Navy enlisted women and men.

Little is known about the contraceptive behavior and beliefs of Navy personnel. Nevertheless, the Navy, in its role as primary medical provider for its personnel, needs to know whether sailors have access to effective birth control and are sufficiently informed about contraception to make wise choices. As part of the Women Aboard Navy Ships Comprehensive Health and Readiness Project conducted at the Naval Health Research Center in San Diego, California, contraceptive use and attitudes toward family planning were assessed through a survey administered to 714 enlisted women and 665 enlisted men on 15 ships. Contraceptive use was not related to gender, age, marital status, pay grade, race, or education. More favorable family planning attitudes were related to contraceptive use. Women and men differed in their attitudes toward family planning, with women's responses more positive than men's. The results highlight the need for research focusing on the effect of attitudes on contraceptive behavior.     

Breastfeeding practices in military families: a 12-month prospective population-based study in the national capital region

Breastfeeding practices in military families have not been widely investigated. The objective of this study was to measure the prevalence and duration of breastfeeding among uniformed families and identify factors associated with breastfeeding. We conducted a prospective study of 253 mothers of new infants from July to December 2004. Initial information gathered included demographic data, feeding choices, and intended duration of breastfeeding. Follow-up surveys were conducted until 12 months postpartum. 51% of mothers were breastfeeding at 6 months and 25% at 1 year. Mothers on active duty were equally likely to breastfeed than non-active duty mothers. Officer mothers were 3 times more likely to breastfeed compared to enlisted mothers (p = 0.005). Mothers with higher education were twice as likely to breastfeed longer (p = 0.015). Families participating in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were 2.5 times less likely to breastfed at 1 year (p < 0.001). Our study shows a higher percentage of women initiating and maintaining breastfeeding compared to national data, but still less than current American Academy of Pediatrics guidelines. Our study suggests that to improve breastfeeding rates among uniformed families, more attention may need to be directed to younger, enlisted mothers and those families in a lower socioeconomic status or receiving WIC assistance.