Cigarette smoking patterns among U.S. military service members before and after separation from the military

PLoS One. 2021 Oct 4;16(10):e0257539. doi: 10.1371/journal.pone.0257539. eCollection 2021.

Abstract

U.S. military Service members have consistently smoked more than the general population and the prevalence of smoking is even higher among U.S. veterans. Our study examined cigarette smoking patterns among Service members before and after military separation to better understand the disproportionate rate of smoking among veterans. Data from the Millennium Cohort Study were used. All study participants were in the military at baseline and some transitioned from the military to civilian life during the observation period. We investigated any impact of military separation on smoking, as well as other potential risk factors for smoking. Overall, we observed higher smoking prevalence among veterans than Service members. Additionally, we found that Service members smoked more while approaching their separation from the military. Longitudinal analysis revealed military separation was not a risk factor for smoking, as we had hypothesized. Baseline smoking was the most influential predictor of current smoking status. Other significant factors included alcohol consumption, life stressors, and mental health conditions, among others. Military separation was not a risk factor for smoking. However, Service members in the process of transitioning out of the military, as well as high alcohol consumers and Service members with mental health conditions, may be at higher risk of smoking. Including smoking prevention/cessation programs in pre-separation counseling sessions and developing smoking screening and cessation programs targeting specific high-risk subgroups may reduce smoking among Service members and veterans.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking / epidemiology
  • Cigarette Smoking / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Military Personnel
  • Prevalence
  • Risk Factors
  • United States
  • Veterans
  • Young Adult

Grants and funding

The Millennium Cohort Study is funded through the Defense Health Program, U.S. Department of Veterans Affairs Office of Research and Development, and the U.S. Department of Veterans Affairs Office of Patient Care Services under Work Unit No. 60002. The funder had no part in the study design, collection of the data, analysis of the data, or writing of manuscript. Leidos, Inc. did not directly fund this study and played no role in the research. Leidos, Inc. provided support in the form of salaries for authors, Chiping Nieh and Teresa Powell, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the “author contributions” section.