Tobacco use among firefighters in the central United States

Abstract

Background This study provides a comprehensive, population-based examination of tobacco use among both career and volunteer firefighters. Methods Data are from a population-based cohort study of randomly selected career (N = 11) and volunteer (N = 13) departments comprised of 677 male firefighters. Results Unadjusted rates of smoking were 13.6% and 17.4% for career and volunteer firefighters, respectively. Smoking rates were less than a comparable occupational group (military personnel) and adult males in the states represented. Smokers were more likely to have been diagnosed with an anxiety disorder (OR = 5.8; P = 0.010), have an elevated CAGE alcohol problem score (OR = 2.9; P = 0.040), and more likely to report driving after drinking too much (OR = 4.5; P = 0.020) compared to never-smokers. Large percentages of career (18.4%) and volunteer (16.8%) firefighters used smokeless tobacco. Conclusions Smoking among firefighters is associated with other significant health and safety risks. High rates of smokeless tobacco use suggest that the fire service is an important target for intervention. Thus, despite strong statements against smoking by the fire service, the need to maintain high levels of health and fitness and relatively low smoking rates, a significant proportion of firefighters continue to use tobacco products.

An examination of the benefits of health promotion programs for the national fire service

“…The prevalence was substantially higher than the general male adult US population and the highest documented among any occupational groups [60], but consistent with previous population-based studies reporting high smokeless tobacco prevalence among male firefighters [22,23]. Reasons for high prevalence of smokeless tobacco use in the fire service overlap substantially with the reasons documented above for reductions in cigarette smoking, along with several other factors: 1) smokeless tobacco use can be concealed easier than smoking even in the context of “no tobacco use contracts”; and 2) smokeless tobacco is sometimes viewed as cheaper than smoking, and is arguably less likely to impact operational readiness and health status [22,23,51]. Greater likelihood of smokeless tobacco use in male firefighters also tends to be associated with problematic alcohol use behaviors [62], another critical behavioral health issue among male career firefighters [24,63].…”

“…Firefighters in WA departments were significantly less likely to have been diagnosed with an anxiety disorder or currently smoke cigarettes. However, it should be noted that even among firefighters in the Standard departments, current smoking prevalence was below men in the general US population and consistent with the low estimates previously documented among firefighters in a population-based study [22]. There are several factors that likely have influenced firefighters in both WA and Standard departments to smoke less including “no smoking contracts” as a condition of employment, disease presumption and indoor smoking laws, the negative impact of smoking on fitness, and firefighters witnessing the detrimental effects of smoking on the health of the people they serve as well as its role in household fires [51].…”

Risk of cancer among firefighters in California, 1988–2007

“…Although many cancers of interest are influenced by lifestyle factors, this study was not able to adjust for these potential confounders. Recent studies found that firefighters working in the central region of the United States were less likely to smoke [Haddock et al, 2011], but have high rates of heavy and binge drinking on their off-duty days [Haddock et al, 2012]. Any differences in lifestyle factors could have biased our estimates in either direction.…”

Alcohol Use and Problem Drinking among Women Firefighters

“…For example, personnel are exposed to a wide range of occupational hazards including heat stress, dehydration, smoke-borne toxins, medical hazards, dangerous environments, and strenuous physical challenges. As a result, firefighters have a high prevalence of occupationally-related medical and mental health disorders compared to the general public (Haddock et al, 2012; Haddock, Jitnarin, Poston, Tuley, & Jahnke, 2011; Jahnke, Poston, Haddock, & Jitnarin, 2013a; Jahnke, Poston, Haddock, et al, 2012; Jahnke, Poston, Jitnarin, & Haddock, 2012; Jitnarin, Haddock, Poston, & Jahnke, 2013; Poston, Haddock, et al, 2011; Poston, Jitnarin, Haddock, Jahnke, & Tuley, 2011; Soteriades et al, 2005; Soteriades, Smith, Tsismenakis, Baur, & Kales, 2011). …”