Dual tobacco user subtypes in the U.S. Air Force: dependence, attitudes, and other correlates of use.
BACKGROUND
To describe the characteristics associated with patterns of daily and dual tobacco use among U.S. Air Force (USAF) personnel transitioning from basic military training to technical training.


METHODS
Cross-sectional survey of USAF personnel in Technical Training School at Lackland Air Force Base (N = 8,956, response rate: 73%). Logistic regression analyzed the association of predictor variables between daily smokers, daily smokeless tobacco (ST) users, daily smokers who used ST nondaily, daily ST users who smoked cigarettes nondaily, and daily users of both cigarettes and ST.


RESULTS
Compared to daily smokers, participants who were daily smokers/nondaily ST users were more likely to be male, would use ST and multiple forms of tobacco in the future, reported more friends using ST and cigarettes, and were more susceptible to tobacco advertising. Compared to daily ST users, daily ST users/nondaily cigarette users were more likely to live in the Midwest, would use multiple forms of tobacco in the future, reported more friends smoked cigarettes and used ST, and were more likely to try a product that claimed to be safer than cigarettes. Daily users of both cigarettes and ST were significantly more likely to be nicotine dependent than daily smokers/nondaily ST users and daily ST users/nondaily smokers.


CONCLUSIONS
Dual users are heterogeneous groups of tobacco users who are at high risk for continued tobacco use. Daily users of both cigarettes and ST have higher levels of nicotine dependence, even when compared to other dual users. Specific interventions targeted at dual users are needed in this increasingly prevalent and high-risk population.
School of Medicine, University of California, San Francisco, San Francisco, CA;
Yoseph
Y
Kram
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN;
Robert C
RC
Klesges
Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; ebbert.jon@mayo.edu.
Jon O
JO
Ebbert
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN;
Wayne
W
Talcott
School of Medicine, University of California, San Francisco, San Francisco, CA; Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA;
Torsten B
TB
Neilands
School of Medicine, University of California, San Francisco, San Francisco, CA; Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA.
Pamela M
PM
Ling
D001290:Attitude; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D058749:Military Facilities; D008889:Military Personnel / Q000706:statistics & numerical data*; D015995:Prevalence; D012574:Schools; D012907:Smoking / Q000453:epidemiology*; D062789:Tobacco Products / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult