Smokeless tobacco use and related factors: A study in the US military population

Objectives: The prevalence of smokeless tobacco use in the US military is alarmingly high. We aimed to identify factors related to smokeless tobacco use among active duty service members. Methods: Participants (N = 2465) from Fort Bragg Army Base, North Carolina and Lackland Air Force Base, Texas completed a self-administered questionnaire. We performed stepwise logistic regression analysis to identify factors statistically associated with smokeless tobacco use. Results: The prevalence of use was higher at the Army base than the Air Force base (32.6% vs 11.6%). White race, cigarette smoking, low perception of harm, and family history of use were significant factors identified at both sites. Compared with users from the Air Force base, users from the army base tended to be current heavy users with longer duration of use, and who started at an older age after joining military and made less effort to quit. Current Department of Defense (DoD) cessation resources were not being utilized by active duty service members. Conclusions: We identified statistically significant factors related to smokeless tobacco among active duty service members. The non-utilization of the DoD cessation resources calls for a cessation strategy that meets the special needs of military personnel.