title: Tobacco use during military deployment.
abstract: BACKGROUND
  Tobacco use among military personnel is associated with significant health care expenditures, lost productivity, and compromised combat readiness. The prevalence remains high among military personnel and may increase in high-risk situations such as deployment. We assessed the prevalence of tobacco use across the deployment cycle, changes in tobacco use (nonuse, continued use, initiation/harm escalation, cessation/harm reduction) during deployment, and the impact of deployment history on tobacco use.
  
  
  METHODS
  Cigarette smoking, smokeless tobacco (ST) use, and dual tobacco use were evaluated among 278U.S. Air Force Security Forces personnel undertaking a 1-year deployment to a high-threat combat environment. Multinomial regression was used to examine prediction of tobacco use patterns both cross-sectionally and longitudinally.
  
  
  RESULTS
  More than half (53%-63%) of all Security Forces used tobacco at all stages of the deployment cycle. Individual tobacco use trajectories showed significant differences in prevalence rates of initiation/harm escalation and cessation/harm reduction when comparing the transition from predeployment to the deployed environment versus returning to postdeployment status. Airmen who had deployed more than once previously had a higher likelihood of using ST use at predeployment and engaging in dual tobacco use during deployment.
  
  
  CONCLUSIONS
  Findings suggest the potential benefit of targeted or universal interventions at each stage of the deployment cycle to reduce the onset, maintenance, or escalation of tobacco use behaviors in the U.S. military.
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA. wtalcott@uthsc.edu
authors.forename: G Wayne
authors.initials: GW
authors.lastname: Talcott
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Cigrang
authors.forename: Deborah
authors.initials: D
authors.lastname: Sherrill-Mittleman
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Snyder
authors.forename: Monty
authors.initials: M
authors.lastname: Baker
authors.forename: Jolyn
authors.initials: J
authors.lastname: Tatum
authors.forename: Daniel
authors.initials: D
authors.lastname: Cassidy
authors.forename: Scott
authors.initials: S
authors.lastname: Sonnek
authors.forename: Christina
authors.initials: C
authors.lastname: Balderrama-Durbin
authors.forename: Robert C
authors.initials: RC
authors.lastname: Klesges
authors.forename: Jon O
authors.initials: JO
authors.lastname: Ebbert
authors.forename: Amy M
authors.initials: AM
authors.lastname: Slep
authors.forename: Richard E
authors.initials: RE
authors.lastname: Heyman
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D064424:Tobacco Use / Q000453:epidemiology*; D014030:Tobacco, Smokeless; D014481:United States