TY - JOUR
T1 - Predicting smokeless tobacco initiation and re-initiation in the United States Air Force
AU - Dunkle, Andrew
AU - Kalpinski, Ryan
AU - Ebbert, Jon
AU - Talcott, Wayne
AU - Klesges, Robert
AU - Little, Melissa A.
N1 - Funding Information:
No financial disclosures were reported by the authors of this paper with the exception of Dr. Ebbert. He reports grants from JHP Pharmaceuticals, Orexigen, and Pfizer outside the submitted work.
Funding Information:
This study was funded by three grants ( DA043468 , DA036510 , DA036510-S1 , DA037273 ) from the National Institute on Drug Abuse (R. Klesges, Principal Investigator). This study was a collaborative endeavor between the US Air Force, the University of Tennessee Health Science Center and the Rectors and Visitors of the University of Virginia via Cooperative Research and Development Agreements (11-118-WHMC-CRADA01 and 17-250-59MDW-C17005).
Funding Information:
The authors gratefully acknowledge the support of 2nd Air Force, the leadership branch for training in the United States Air Force. This study was funded by three grants (DA043468, DA036510, DA036510-S1, DA037273)from the National Institute on Drug Abuse (R. Klesges, Principal Investigator). This study was a collaborative endeavor between the US Air Force, the University of Tennessee Health Science Center and the Rectors and Visitors of the University of Virginia via Cooperative Research and Development Agreements (11-118-WHMC-CRADA01 and 17-250-59MDW-C17005). None. No financial disclosures were reported by the authors of this paper with the exception of Dr. Ebbert. He reports grants from JHP Pharmaceuticals, Orexigen, and Pfizer outside the submitted work. The opinions expressed on this document are solely those of the authors and do not represent an endorsement by or the views of the United States Air Force, the Department of Defense, or the United States Government. The voluntary, fully informed consent of the subjects used in this research was obtained as required by 32 CFR 219 and DODI 3216.02_AFI 40-402.
Publisher Copyright:
© 2018 The Authors
PY - 2019/6
Y1 - 2019/6
N2 - Introduction: Active Duty United States Air Force (USAF)members have substantially higher rates of smokeless tobacco (ST)use than the general population. Methods: We longitudinally assessed demographics, tobacco use, intrapersonal factors, and interpersonal factors to determine associations with the initiation or re-initiation of ST in the year following a period of forced abstinence among 2188 newly recruited Airmen. Logistic regression analyses were conducted to examine associations between baseline predictors and ST use at one-year follow-up. Results: In the final multivariate models compared to never users, the strongest predictors of ST use initiation after BMT were male gender (adjusted OR 8.93, 95% CI 3.82, 20.88), pre-BMT cigarette and cigar use (adjusted OR 1.60, 95% CI 1.00, 2.57; adjusted OR 2.50, 95% CI 1.66, 3.81 respectively). Compared to former ST users, the strongest predictors of re-initiation were male gender (adjusted OR 10.68, 95% CI 2.25, 50.62)and intentions to use ST (adjusted OR 2.10, 95% CI 1.42, 3.12). Compared to initiators of ST, the strongest predictors of re-initiation were intentions to use ST and peer use (adjusted OR 3.26, 95% CI 1.94, 5.49; OR 2.55, 95% CI 1.92, 3.41 respectively). Conclusions: Our results suggest that initiators may be exploring and viewing ST as a less harmful alternative to cigarette smoking and ST users reporting intentions to use ST in the future often return to use. The development of interventions able to disrupt the link between intentions to use tobacco and future tobacco use in the USAF is vital.
AB - Introduction: Active Duty United States Air Force (USAF)members have substantially higher rates of smokeless tobacco (ST)use than the general population. Methods: We longitudinally assessed demographics, tobacco use, intrapersonal factors, and interpersonal factors to determine associations with the initiation or re-initiation of ST in the year following a period of forced abstinence among 2188 newly recruited Airmen. Logistic regression analyses were conducted to examine associations between baseline predictors and ST use at one-year follow-up. Results: In the final multivariate models compared to never users, the strongest predictors of ST use initiation after BMT were male gender (adjusted OR 8.93, 95% CI 3.82, 20.88), pre-BMT cigarette and cigar use (adjusted OR 1.60, 95% CI 1.00, 2.57; adjusted OR 2.50, 95% CI 1.66, 3.81 respectively). Compared to former ST users, the strongest predictors of re-initiation were male gender (adjusted OR 10.68, 95% CI 2.25, 50.62)and intentions to use ST (adjusted OR 2.10, 95% CI 1.42, 3.12). Compared to initiators of ST, the strongest predictors of re-initiation were intentions to use ST and peer use (adjusted OR 3.26, 95% CI 1.94, 5.49; OR 2.55, 95% CI 1.92, 3.41 respectively). Conclusions: Our results suggest that initiators may be exploring and viewing ST as a less harmful alternative to cigarette smoking and ST users reporting intentions to use ST in the future often return to use. The development of interventions able to disrupt the link between intentions to use tobacco and future tobacco use in the USAF is vital.
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U2 - 10.1016/j.abrep.2018.11.001
DO - 10.1016/j.abrep.2018.11.001
M3 - Article
AN - SCOPUS:85057268844
SN - 2352-8532
VL - 9
JO - Addictive Behaviors Reports
JF - Addictive Behaviors Reports
M1 - 100142
ER -