title: 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.
authors.affiliation: Center for Fire, Rescue, & EMS Health Research, National Development and Research Institutes, Inc., Leawood, Kansas, USA. keithhaddock@hopehri.com, haddock@ndri.org
authors.forename: C Keith
authors.initials: CK
authors.lastname: Haddock
authors.forename: Nattinee
authors.initials: N
authors.lastname: Jitnarin
authors.forename: Walker S C
authors.initials: WS
authors.lastname: Poston
authors.forename: Brianne
authors.initials: B
authors.lastname: Tuley
authors.forename: Sara A
authors.initials: SA
authors.lastname: Jahnke
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D001008:Anxiety Disorders / Q000453:epidemiology; D001334:Automobile Driving / Q000706:statistics & numerical data; D061388:Firefighters / Q000706:statistics & numerical data*; D015438:Health Behavior; D006801:Humans; D008297:Male; D015146:Midwestern United States / Q000453:epidemiology; D010101:Oxygen Consumption; D010809:Physical Fitness; D012907:Smoking / Q000453:epidemiology*; D014838:Volunteers