Prevalence and Correlates of Tobacco and Nicotine Containing Product Use in a Sample of United States Air Force Trainees

Abstract

Introduction: 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. Methods: 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). Results: 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 white, and single with a high school degree or General Education Development. Hookah was the most endorsed for intentions to use, and along with e-cigarettes, had the lowest perception of harm. While prevalence of most products remained constant across entering cohorts, the prevalence of e-cigarettes showed significant linear increase. Conclusions:The prevalence of TNCP use is high across cohorts of Airmen. Remarkably high estimates of future intentions to use and low perceptions of harm for emerging products suggest that intervention efforts should be directed at multiple forms of TNCP use to address this important public health issue.

The comparative effectiveness of two brief tobacco interventions in the U.S. Air Force: Perceived harm and intentions-to-use of tobacco products

“…Therefore, here we compare the effect sizes for the 5 products that were common to both studies: cigarettes, smokeless tobacco, cigarillos, e-cigarettes and hookah. These products are also most commonly used among the Airmen 7 . In both studies Airmen were asked to rate the harm of each of the products, and to indicate the likelihood of use within the next 12 months.…”

“…The BTI intervention is based on prior research and tobacco control programs in the military 7,[23][24][25][26] . It is approximately 40 minutes long, delivered in a group setting, interactive with the participants and based on principles of motivational interviewing 13,27 .…”

“…The largest intervention effects are observed for hookah, and e-cigarettes to some extent. These products are emerging in popularity and social use and tend to be perceived as less or even harmless 7,23 . BTI intervention had a noticeably large effect on increasing a perception of harm for these two products among past users and nonusers.…”

“…Common tobacco products used in the US Air Force (USAF) are: cigarettes (11.2%), smokeless tobacco (8.6%), cigarillos (8.7%), hookah (10.4%) and e-cigarettes (6%) 7 . Military training and service begins with 10.5 weeks of forced abstinence.…”

“…Military training and service begins with 10.5 weeks of forced abstinence. At the end of this period, nearly 2/3 of trainees are confident that they won't return to tobacco products, although the majority do 7 . In fact, nearly 70% of tobacco initiation/re-initiation occurs during Technical Training 8 .…”