title: Associations Among Back and Extremity Pain With Alcohol, Tobacco, and Caffeine Use Among US Air Force Pararescuemen.
abstract: BACKGROUND
  Caffeine, tobacco, and alcohol are the most widely used substances globally, but the majority of research on the associations among legal substance use and physical health has focused on the general population, not elite military personnel. The purpose of the current study was to describe patterns of tobacco, alcohol, and caffeine use and to examine the relationship of legal substance use with self-reported physical health complaints among US Air Force Pararescuemen (PJs) and Combat Rescue Officers (CROs).
  
  
  METHODS
  Participants were 196 US PJs and CROs. Participants completed self-report measures of legal drug use and somatic symptoms. Generalized linear modeling with robust maximum likelihood estimation was used for multivariate regression analyses. Chi-square analyses were conducted for univariate comparisons of categorical variables.
  
  
  RESULTS
  Reported rates of tobacco use (28.2%), alcohol consumption (83.2%), and regular caffeine consumption (88.8%) were similar to the general population. Daily caffeine intake was significantly higher among participants reporting they were bothered a lot by back pain [Wald χ2(2)=11.39; ρ=.003] and extremity pain [Wald χ2(2)=11.39; ρ=.003], even when controlling for age and deployment history. Participants with severe extremity pain also reported drinking approximately twice as many alcoholic beverages per week (mean, 5.46; standard error [SE], 0.91) than participants who were bothered a little (mean, 2.88; SE, 0.54) or not bothered at all (mean, 2.88; SE, 0.52) by extremity pain.
  
  
  CONCLUSIONS
  Back and extremity pain is associated with greater caffeine and alcohol consumption among PJs.
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Bryan
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Wolfe
authors.forename: Chad E
authors.initials: CE
authors.lastname: Morrow
authors.forename: James A
authors.initials: JA
authors.lastname: Stephenson
authors.forename: Jeremy
authors.initials: J
authors.lastname: Haskell
authors.forename: AnnaBelle O
authors.initials: AO
authors.lastname: Bryan
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000428:Alcohol Drinking / Q000453:epidemiology*; D001416:Back Pain / Q000453:epidemiology*; D002110:Caffeine / Q000008:administration & dosage*; D005121:Extremities; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D059352:Musculoskeletal Pain / Q000453:epidemiology*; D018635:Rescue Work; D057566:Self Report; D064424:Tobacco Use / Q000453:epidemiology*; D014481:United States; D055815:Young Adult
chemical_list: D002110:Caffeine