title: The Impact of Unit Membership on Smoking Among Soldiers.
abstract: Cultural, organizational, and dyadic influences have been found to be associated with smoking in the military while group-level influences have been identified in the general population. However, there are few studies examining group-level influences in the military and none using group-level analyses. Such studies are essential for understanding how to optimally forestall or cease smoking. This study, using mixed effects modelling, examined whether unit membership influenced smoking behavior in soldiers from brigade combat teams. Unit membership was assessed in 2008 to 2009 at the company level (n = 2204) and in 2012 at the platoon level (n = 452). Smoking was assessed by the number of daily cigarettes smoked (range: 0-99) with smoking status (nonsmoker vs. smoker) and smoking level (none, smoker, and heavy [20 + cigarettes/day]) as the outcomes. For both samples, unit membership was not significantly associated with a soldier's propensity to smoke when comparing either all smokers to nonsmokers or heavy smokers to smokers. These results suggest typical military unit-level training programs are unlikely to be the most effective mode of intervention for smoking prevention or cessation. Smoking rates in the military may be influenced instead by small group or individual relationships or by overall military culture.
authors.affiliation: Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Toblin
authors.affiliation: Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: James A
authors.initials: JA
authors.lastname: Anderson
authors.affiliation: Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: Lyndon A
authors.initials: LA
authors.lastname: Riviere
authors.affiliation: Military Operational Medicine Research Program, U.S. Army Medical Research and Materiel Command, 504 Scott Street, Fort Detrick, MD 21702.
authors.forename: Dennis
authors.initials: D
authors.lastname: McGurk
authors.affiliation: Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: Maurice L
authors.initials: ML
authors.lastname: Sipos
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D000067074:Peer Influence; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult