title: Tobacco use pattern among a national firefighter cohort.
abstract: BACKGROUND
  To date, there have been no large-scale, national epidemiological studies of tobacco use patterns among firefighters, particularly with a focus on smokeless tobacco (SLT) and dual use with cigarettes. While rates of firefighters' smoking are relatively low compared to the general population, SLT use typically is substantially higher than the populations they protect. In the current study, we systemically examine tobacco use, including SLT and dual use, and the health-related profiles of various tobacco use groups in a national sample of career firefighters.
  
  
  METHODS
  Data are from a national cohort study of career departments (N = 20) comprised of 947 male firefighters.
  
  
  RESULTS
  Among 947 participants, 197 (21%) were tobacco users, of which, 34.5% used cigarettes, 53.2% used SLT, and 12.2% used both cigarettes and SLT. Adjusted rates of smoking, SLT use, and dual use were 13.2%, 10.5%, and 12.2%, respectively. Tobacco users of all types were significantly younger and had served fewer years in fire service and were significantly more likely to engage in heavy and binge drinking, as well as more likely to show signs of depressive symptoms compared to nontobacco users.
  
  
  CONCLUSIONS
  Detailed information on tobacco use pattern will aid in better understanding what factors are contributing to the high rates of SLT and dual use among firefighters in order to guide and develop an appropriate treatment program for the fire service.
authors.affiliation: Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS; jitnarin@ndri.org.
authors.forename: Nattinee
authors.initials: N
authors.lastname: Jitnarin
authors.affiliation: Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS;
authors.forename: Walker S C
authors.initials: WS
authors.lastname: Poston
authors.affiliation: Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS;
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Haddock
authors.affiliation: Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS;
authors.forename: Sara A
authors.initials: SA
authors.lastname: Jahnke
authors.affiliation: Division of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX.
authors.forename: Rena S
authors.initials: RS
authors.lastname: Day
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D061388:Firefighters / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016272:Occupational Health; D013781:Texas; D062789:Tobacco Products; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control; D014030:Tobacco, Smokeless