Tobacco Initiation and Cessation Among New Soldiers

Rates of tobacco and alcohol use are higher among junior enlisted military personnel !ban the rates for similar age civilian populations or for older military personnel (see Bray et al. 1999). Further, annual data ITom the Monitoring the Future and the National Household Survey on Drug Abuse between 1992 and the 1998, show an unprecedented increase in the rates of use of tobacco, alcohol, and illicit drug use among middle and high school youth, rates that had been in decline &om the late I 970s. Further, the most recent data &om the World Wide Survey show an increase in tobacco and alcohol use among junior enlisted military personnel. There is an inverse relationship between socioeconomic status, tobacco use and related problems; the higher the SES (education, income, status of occupation), the higher the likelihood of "current" smoking. This statistical relationship is opposite that found 50 years ago when the higher the status, the greater the likelihood of smoking. The relationship between tobacco use and dependence and racelethnicity is not clear. African-American youth are less likely to smoke than are Anglo youth, and there is inadequate information available on differences in dependence reliably measured by racelethnicity. A substantial amount is known about patterns of smoking among middle and high school youth, but there is a dearth of data about young adults and smoking, particularly among coJlege age youth who are not in coJlege, and not sufficient information about coJlege age youth. Considerably more data are available on young adults of coJlege age, in and not in coJlege, and alcohol consumption. The average age at onset of both tobacco and alcohol use is around 15-16 when the data used are not right censored. It is obvious that most who enter the military in their late teens or early twenties are already exposed to and perhaps have consistent patterns of tobacco and alcohol use. There are different policies and regulations regarding tobacco and alcohol use in the various branches of the military. Very little is known about how those entering the Army with existing patterns of tobacco and alcohol use respond to the forced abstinence of basic training and into AlT. The effectiveness of the public health policy approach taken by the Army (and other services as well) has not been systematically examined. Further, even studies in the general civilian population have often failed to measure important constructs such as nicotine dependence and important potential colTelates of smoking and dependence such as depression, stress, and anxiety sensitivity. It is possible there are differences in smoking and drinking by occupational specialty in the Army. Because there is a tendency in the military to house in the same facilities those studying the same occupational specialty, it is possible to examine the relationship of both individual-level and enviromnentallevel influences on tobacco use.