Brown Janice M, Anderson Goodell Erin M, Williams Jason, Bray Robert M
RTI International, Research Triangle Park, Durham NC.
Bloomberg School of Public Health, Johns Hopkins University, Baltimore MD.
Mil Med. 2018 Jul 1;183(7-8):e231-e239. doi: 10.1093/milmed/usx021.
Cigarette smoking can have negative consequences in military populations including injury, reduced physical endurance, higher frequency of sick days, and reduced combat readiness. This study used the socioecological model to understand individual, interpersonal, and organizational influences on cigarette smoking among military members.
The sample for this secondary analysis was drawn from personnel at 24 large U.S. military installations, six from each service branch. Analyses included 4,728 personnel who were classified as current cigarette smokers. Generalized linear mixed models were used to estimate the associations among risk and protective factors from multiple ecological levels for smoking intensity and nicotine dependence.
Smoking to fit in with one's unit, being in the Army, smoking as a reaction to stress, and work-related stressors were all related to increased intensity of smoking and nicotine dependence. More active coping was associated with lower nicotine dependence and reduced smoking intensity.
Results based on the socioecological model identify influencing factors and suggest possible interventions for smoking cessation. Reducing tobacco use in the military will require coordinated interventions that address multilevel determinants of use and improve military health. This is important to the strategic alignment of policy and services across the continuum of health care needs.
吸烟会给军人带来负面影响，包括受伤、身体耐力下降、病假天数增加以及战斗准备状态降低。本研究采用社会生态模型来了解个体、人际和组织因素对军人吸烟行为的影响。
本次二次分析的样本来自美国24个大型军事基地的人员，每个军种分支各有6个基地。分析纳入了4728名被归类为当前吸烟者的人员。使用广义线性混合模型来估计来自多个生态层面的风险和保护因素与吸烟强度及尼古丁依赖之间的关联。
为了融入所在单位而吸烟、在陆军服役、因压力而吸烟以及与工作相关的压力源均与吸烟强度增加和尼古丁依赖有关。更多积极的应对方式与较低的尼古丁依赖和降低的吸烟强度相关。
基于社会生态模型的结果确定了影响因素，并提出了可能的戒烟干预措施。减少军队中的烟草使用将需要协调一致的干预措施，以解决使用的多层次决定因素并改善军人健康。这对于在连续的医疗保健需求中使政策和服务实现战略一致非常重要。
