The U.S. Military is a high-risk population for tobacco use given their demographics (young, predominantly male, high minority prevalence), psychosocial risk factors (rebelliousness and risk-taking behaviors, high prevalence of alcohol abuse), stress of deployment, and targeted marketing by the tobacco industry. Currently, more than 30% of active duty military personnel use tobacco and that prevalence has been increasing since 1998. Military personnel are considered a highly vulnerable population. Advancing our understanding of the prevalence, incidence and diversity of tobacco product use in this population will improve scientific knowledge and inform FDA tobacco regulatory decision-making. We were funded FDA supplemental funding to collect preliminary process and formative information as well as instrument validation in a small cohort of military personnel assessing traditional and new and emerging tobacco products. In the current application, we are proposing a logical extension of these efforts by expanding our assessment of new and emerging tobacco products, along with concomitant risk factors of tobacco use with a sufficient sample size to evaluate small, but clinically significant subgroup (e.g., gender, ethnicity) and tobacco type (e.g., e-cigarettes) differences. We will collect data on 30,000 Airmen, Air National Guard, and Reservists by administering surveys at three time-points (baseline, 1 year, 2 years) at the four active Technical Training Air Forces Bases (AFBs). To determine the optimal length of time between survey assessments, we will first conduct a pilot investigation to determine the reproducibility, feasibility, and amount of new information learned by evaluating participants Reservists every three months. Thus, the specific aims of the current study are to: (1) Determine the prevalence and incidence of traditional tobacco products, new and emerging tobacco products, and multiple tobacco use behaviors; (2) Determine social cognitive (e.g., self-efficacy) and affective factors (e.g., perceptions, attitudes, beliefs) associated with the use of new and emerging tobacco products, ST, and little cigars; (3) Evaluate how marketing claims of reduced carcinogen exposure (e.g., switching from cigarettes to ST) influence perceptions and beliefs about risk and harm of different tobacco product use; (4) Assess the association between awareness of tobacco marketing strategies (e.g., free samples and price promotions), how they receive information about tobacco products, and tobacco use behaviors among Airmen; and (5) To directly compare tobacco initiation, resumption, and predictors of tobacco use between (a) Airmen (who remain active duty) with (b) National Guard/Reservists (who train and then return to civilian life). This will allow a direct comparison of those who remain in the military environment versus those who return to the civilian sectors.
The rates of both traditional (smoking, smokeless tobacco) in the US military are among the highest in the country. This study will determine the rates and the determinants of new, emerging, and traditional tobacco use and initiation in the military.
| Kong, Amanda Y; Golden, Shelley D; Myers, Allison E et al. (2018) Availability, price and promotions for cigarettes and non-cigarette tobacco products: an observational comparison of US Air Force bases with nearby tobacco retailers, 2016. Tob Control : |
| Linde, Brittany D; Ebbert, Jon O; Schroeder, Darrell R et al. (2017) Smokeless tobacco use among United States Air Force trainees. Subst Abus 38:278-284 |
