MacGregor Andrew J, Dougherty Amber L, Khodr Zeina G, McAnany Jennifer, McCabe Cameron T, Zouris James M, Haile Yohannes G, Rohrbeck Patricia
Epidemiology and Data Management Support Department, Naval Health Research Center, San Diego, California.
Epidemiology and Data Management Support Department, Naval Health Research Center, San Diego, California; Leidos, Inc., San Diego, California.
Am J Prev Med. 2025 Mar;68(3):437-445. doi: 10.1016/j.amepre.2024.10.016. Epub 2024 Oct 28.
U.S. military personnel have a high prevalence of alcohol misuse, which can adversely affect force readiness. The objective of this study was to identify pre-service predictors of new-onset alcohol misuse among male Marines.
Data for this retrospective cohort study were collected from male U.S. Marines who completed a baseline survey at the beginning of military training from 2013 to 2021 and a standard health assessment 12-36 months later (n=28,337). An Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) score ≥4 indicated alcohol misuse. Independent predictors of alcohol misuse were evaluated using a modified Poisson regression to calculate adjusted risk ratios (aRRs) and 95% CIs. Analyses were conducted between 2022 and 2024.
The incidence of new-onset alcohol misuse was 16.3% (n=4,632). In the final multivariable model, the strongest predictor of new-onset alcohol misuse was turning 21 years old during the study period (aRR=3.70; 95% CI=3.40, 4.03). Pre-service tobacco use (aRR=1.32; 95% CI=1.22, 1.43) and some pre-service alcohol use (AUDIT-C score 1-3: aRR=1.32; 95% CI=1.24, 1.40) were also associated with new-onset alcohol misuse.
Multiple pre-service predictors were associated with new-onset alcohol misuse in male Marines. These findings should be considered when screening for alcohol misuse and developing clinical interventions to mitigate adverse impacts of alcohol misuse in the military.
