Drinking motivations in UK serving and ex-serving military personnel

Irizar, Patricia; Leightley, Daniel; Stevelink, Sharon; Rona, Roberto; Jones, Norman; Gouni, Katerina; Puddephatt, Jo-Anne; Fear, Nicola T.; Wessely, Simon; Goodwin, Laura

doi:10.1093/occmed/kqaa003

Cited by 22 publications

(20 citation statements)

References 26 publications

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“…There may be several explanations for the reduction in hazardous drinking. Alcohol has often been used as a social bonding tool in Armed Forces community, 36 37 therefore the closing or restrictions placed on the hospitality business may explain the reduction in alcohol consumption. Alternatively, this may represent a general population trend observed in the UK population where high-risk drinkers have reduced their alcohol consumption.…”

Section: Discussionmentioning

confidence: 99%

UK veterans’ mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study

et al. 2021

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ObjectiveTo investigate the impact of the COVID-19 pandemic on the health and well-being of UK ex-service personnel (veterans) before and during the pandemic, and to assess associations of COVID-19 experiences and stressors with mental health, alcohol use and loneliness.DesignAn additional wave of data was collected from a longitudinal cohort study of the UK Armed Forces.SettingOnline survey June–September 2020.ParticipantsCohort members were included if they had completed a questionnaire at phase 3 of the King’s Centre for Military Health Research health and well-being study (2014–2016), had left the Armed Forces after regular service, were living in the UK, had consented to follow-up and provided a valid email address. Invitation emails were sent to N=3547 with a 44% response rate (n=1562).Primary outcome measuresCommon mental health disorders (CMDs) (measured using the General Health Questionnaire, 12 items—cut-off ≥4), hazardous alcohol use (measured using the Alcohol Use Disorder Identification Test, 10 items—cut off ≥8) and loneliness (University of California, Los Angeles, Loneliness Scale— 3 items-cut-off ≥6).ResultsVeterans reported a statistically significant decrease in hazardous drinking of 48.5% to 27.6%, while CMD remained stable (non-statistically significant increase of 24.5% to 26.1%). 27.4% of veterans reported feelings of loneliness. The COVID-19 stressors of reporting difficulties with family/social relationships, boredom and difficulties with health were statistically significantly associated with CMD, hazardous drinking and loneliness, even after adjustment for previous mental health/hazardous alcohol use.ConclusionsOur study suggests a COVID-19 impact on veterans’ mental health, alcohol use and loneliness, particularly for those experiencing difficulties with family relationships. Veterans experienced the pandemic in similar ways to the general population and in some cases may have responded in resilient ways. While stable levels of CMD and reduction in alcohol use are positive, there remains a group of veterans who may need mental health and alcohol treatment services.

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Section: Discussionmentioning

confidence: 99%

UK veterans’ mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study

et al. 2021

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“…The higher proportions of harmful drinking in military personnel may relate to coping motivations for drinking, hence the higher proportions of comorbid PTSD and harmful alcohol use. Recent findings showed that military personnel who drink to cope are more likely to drink harmfully and binge drink (Irizar, Leightley et al, 2020 ). Alcohol use has historically been part of military culture, often used to create social bonds or to destress following deployment (Ames, Cunradi, Moore, & Stern, 2007 ; Jones & Fear, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

“…The pattern of harmful drinking in police employees is similar to that of the general population, which shows that alcohol use is decreasing in younger people but increasing in older people (Bardsley et al, 2018 ; Oldham et al, 2020 ). Younger military personnel are more likely than those over 50 to report social pressure motivations for drinking (Irizar, Leightley et al, 2020 ) and may be more susceptible to military culture, which has historically facilitated risky drinking (Ames et al, 2007 ; Jones & Fear, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study

Irizar

Stevelink

Pernet

et al. 2021

European Journal of Psychotraumatology

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Background : British Armed Forces’ and Police Forces’ personnel are trained to operate in potentially traumatic conditions. Consequently, they may experience post-traumatic stress disorder (PTSD), which is often comorbid with harmful alcohol use. Objective : We aimed to assess the proportions, and associations, of probable PTSD and harmful alcohol use among a covariate-balanced sample of male military personnel and police employees. Methods : Proportions of probable PTSD, harmful alcohol use, and daily binge drinking, were explored using data from the police Airwave Health Monitoring Study (2007–2015) ( N = 23,826) and the military Health and Wellbeing Cohort Study (phase 2: 2007–2009, phase 3: 2014–2016) ( N = 7,399). Entropy balancing weights were applied to the larger police sample to make them comparable to the military sample on a range of pre-specified variables (i.e. year of data collection, age and education attainment). Multinomial and logistic regression analyses determined sample differences in outcome variables, and associated factors (stratified by sample). Results : Proportions of probable PTSD were similar in military personnel and police employees (3.67% vs 3.95%), although the large sample size made these borderline significant (Adjusted Odds Ratio (AOR): 0.84; 95% Confidence Intervals (CI): 0.72 to 0.99). Clear differences were found in harmful alcohol use among military personnel, compared to police employees (9.59% vs 2.87%; AOR: 2.79; 95% CI: 2.42 to 3.21). Current smoking, which was more prevalent in military personnel, was associated with harmful drinking and binge drinking in both samples but was associated with PTSD in military personnel only. Conclusions : It is generally assumed that both groups have high rates of PTSD from traumatic exposures, however, low proportions of PTSD were observed in both samples, possibly reflecting protective effects of unit cohesion or resilience. The higher level of harmful drinking in military personnel may relate to more prominent drinking cultures or unique operational experiences.

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“…This pattern is similar among the UK AF, with less than half of UK AF hazardous drinkers recognizing that they have an alcohol problem [ 8 ]. There is also a culture of heavy alcohol use in the UK AF, which is encouraged by the social environment and carries on after personnel leave service [ 4 , 9 , 10 ]. Therefore, leaving service could provide an opportunity to initiate behavior change in settings with less peer pressure to conform to social norms and promote alcohol awareness.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Efficacy of a Mobile App (Drinks:Ration) and Personalized Text and Push Messaging to Reduce Alcohol Consumption in a Veteran Population: Protocol for a Randomized Controlled Trial

Leightley¹,

Rona²,

Shearer³

et al. 2020

JMIR Res Protoc

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Background Alcohol misuse is higher in the UK Armed Forces than in the general population. Previous research has shown that interventions delivered via smartphones are efficacious in promoting self-monitoring of alcohol use, have utility in reducing alcohol consumption, and have a broad reach. Objective This single-blinded randomized controlled trial (RCT) aims to assess the efficacy of a 28-day brief alcohol intervention delivered via a smartphone app (Drinks:Ration) in reducing weekly self-reported alcohol consumption between baseline and 3-month follow-up among veterans who drink at a hazardous or harmful level and receive or have received support for mental health symptoms in a clinical setting. Methods In this two-arm, single-blinded RCT, a smartphone app that includes interactive features designed to enhance participants’ motivation and personalized messaging is compared with a smartphone app that provides only government guidance on alcohol consumption. The trial will be conducted in a veteran population that has sought help through Combat Stress, a UK veteran’s mental health charity. Recruitment, consent, and data collection will be carried out automatically through the Drinks:Ration platform. The primary outcome is the change in self-reported weekly alcohol consumption between baseline (day 0) and 3-month follow-up (day 84) as measured using the Time-Line Follow back for Alcohol Consumption. Secondary outcome measures include (1) change in the baseline to 3-month follow-up (day 84) Alcohol Use Disorder Identification Test score and (2) change in the baseline to 3-month follow-up (day 84) World Health Organization Quality of Life-BREF score to assess the quality of adjusted life years. Process evaluation measures include (1) app use and (2) usability ratings as measured by the mHealth App Usability Questionnaire. The primary and secondary outcomes will also be reassessed at the 6-month follow-up (day 168) to assess the longer-term benefits of the intervention, which will be reported as a secondary outcome. Results The study will begin recruitment in October 2020 and is expected to require 12 months to complete. The study results will be published in 2022. Conclusions This study assesses whether a smartphone app is efficacious in reducing self-reported alcohol consumption in a veteran population that has sought help through Combat Stress using personalized messaging and interactive features. This innovative approach, if successful, may provide a means to deliver a low-cost health promotion program that has the potential to reach large groups, in particular those who are geographically dispersed, such as military personnel. Trial Registration ClinicalTrials.gov NCT04494594; https://clinicaltrials.gov/ct2/show/NCT04494594 International Registered Report Identifier (IRRID) PRR1-10.2196/19720

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Drinking motivations in UK serving and ex-serving military personnel

Cited by 22 publications

References 26 publications

UK veterans’ mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study

UK veterans’ mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study

Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study

Evaluating the Efficacy of a Mobile App (Drinks:Ration) and Personalized Text and Push Messaging to Reduce Alcohol Consumption in a Veteran Population: Protocol for a Randomized Controlled Trial

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