title: Longitudinal Investigation of Smoking Initiation and Relapse Among Younger and Older US Military Personnel.
abstract: OBJECTIVE
  We examined whether military service, including deployment and combat experience, were related to smoking initiation and relapse.
  
  
  METHODS
  We included older (panel 1) and younger (panel 2) participants in the Millennium Cohort Study. Never smokers were followed for 3 to 6 years for smoking initiation, and former smokers were followed for relapse. Complementary log-log regression models estimated the relative risk (RR) of initiation and relapse by military exposure while adjusting for demographic, health, and lifestyle factors.
  
  
  RESULTS
  Deployment with combat experience predicted higher initiation rate (panel 1: RR = 1.44; 95% confidence interval [CI] = 1.28, 1.62; panel 2: RR = 1.26; 95% CI = 1.04, 1.54) and relapse rate (panel 1 only: RR = 1.48; 95% CI = 1.36, 1.62). Depending on the panel, previous mental health disorders, life stressors, and other military and nonmilitary characteristics independently predicted initiation and relapse.
  
  
  CONCLUSIONS
  Deployment with combat experience and previous mental disorder may identify military service members in need of intervention to prevent smoking initiation and relapse.
authors.affiliation: Edward J. Boyko, Alyson J. Littman, and Amber D. Seelig are with the Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs (VA) Puget Sound Health Care System, WA. Charles Maynard is with the Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research and Development, VA Puget Sound Health Care System, VA Eastern Colorado, Denver. Daniel W. Trone and Isabel G. Jacobson are with the Department of Defense Center for Deployment Health Research, Naval Health Research Center, San Diego, CA. Nancy F. Crum-Cianflone is with the Naval Medical Center, San Diego, CA. Arthur V. Peterson and Jonathan B. Bricker are with the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Trone
authors.forename: Arthur V
authors.initials: AV
authors.lastname: Peterson
authors.forename: Isabel G
authors.initials: IG
authors.lastname: Jacobson
authors.forename: Alyson J
authors.initials: AJ
authors.lastname: Littman
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.forename: Amber D
authors.initials: AD
authors.lastname: Seelig
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Crum-Cianflone
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Bricker
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D008889:Military Personnel; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications; D014481:United States / Q000453:epidemiology; D014857:Warfare