Smokeless Tobacco Use in the United States Military: A Systematic Review

Abstract

smokeless tobacco (ST) use is increasing (Institute of Medicine [IOM], 2009). Furthermore, many military personnel use cigarettes and ST concurrently, compounding the health hazards of using either product alone and maintaining the addiction to nicotine (IOM, 2009). According to a recent survey of active duty personnel, nearly half (41.2%) reported using one or more forms of tobacco in the past month (Rae Olmsted, Bray, Guzman, Williams, & Kruger, 2011). Significant differences in ST use rates exist between the military and civilian populations. In 2008, the overall prevalence of ST use among active duty personnel was 14% (Bray et al., 2009). In comparison, 3.5% of civilians (≥18 years) used ST (Substance Abuse and Mental Health Services Administration [SAMHSA], 2010). In both populations, ST use is highest among young adult (aged 18-25) White males. However, even in this demographic group, those in the military use ST at almost twice the rate of their civilian counterparts (19% vs. 11.4%; Bray et al., 2009; SAMHSA, 2010). Significant differences also exist in rates of ST use between the individual service branches. The Marine Corps has the highest prevalence (22%), followed by the Army (16%), Coast Guard (13%), Navy (10%), and Air Force (9%; Bray et al., 2009). ST use is associated with numerous adverse health outcomes, including cancers of the mouth, throat, and pancreas

Validation of Veterans Affairs Electronic Medical Record Smoking Data Among Iraq- and Afghanistan-Era Veterans

“…In the US, smoking takes a heavy toll because of tobaccorelated illness, death, medical expenditures, and lost productivity. [1][2][3] Military service increases risk for initiation and maintenance of cigarette smoking, [4][5][6][7][8] and younger veterans endorse high rates of tobacco use. Among Veterans Affairs (VA) patients who served during conflicts in Iraq and/or Afghanistan, 50% have a lifetime history of smoking and 24% currently smoke.…”