New, Emerging, and Traditional Tobacco Use in the Military

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 DESCRIPTION (provided by applicant): The U.S. Military is a high-risk population for tobacco use given their demographics (young, predominantly male, high minority prevalence), psychosocial risk factors (rebelliousness and risk-taking behaviors, high prevalence of alcohol abuse), stress of deployment, and targeted marketing by the tobacco industry. Currently, more than 30% of active duty military personnel use tobacco and that prevalence has been increasing since 1998. Military personnel are considered a highly vulnerable population. Advancing our understanding of the prevalence, incidence and diversity of tobacco product use in this population will improve scientific knowledge and inform FDA tobacco regulatory decision-making. We were funded FDA supplemental funding to collect preliminary process and formative information as well as instrument validation in a small cohort of military personnel assessing traditional and new and emerging tobacco products. In the current application, we are proposing a logical extension of these efforts by expanding our assessment of new and emerging tobacco products, along with concomitant risk factors of tobacco use with a sufficient sample size to evaluate small, but clinically significant subgroup (e.g., gender, ethnicity) and tobacco type (e.g., e-cigarettes) differences. We will collect data on 30,000 Airmen, Air National Guard, and Reservists by administering surveys at three time-points (baseline, 1 year, 2 years) at the four active Technical Training Air Forces Bases (AFBs). To determine the optimal length of time between survey assessments, we will first conduct a pilot investigation to determine the reproducibility, feasibility, and amount of new information learned by evaluating participants Reservists every three months. Thus, the specific aims of the current study are to: (1) Determine the prevalence and incidence of traditional tobacco products, new and emerging tobacco products, and multiple tobacco use behaviors; (2) Determine social cognitive (e.g., self-efficacy) and affective factors (e.g., perceptions, attitudes, beliefs) associated with the use of new and emerging tobacco products, ST, and little cigars; (3) Evaluate how marketing claims of reduced carcinogen exposure (e.g., switching from cigarettes to ST) influence perceptions and beliefs about risk and harm of different tobacco product use; (4) Assess the association between awareness of tobacco marketing strategies (e.g., free samples and price promotions), how they receive information about tobacco products, and tobacco use behaviors among Airmen; and (5) To directly compare tobacco initiation, resumption, and predictors of tobacco use between (a) Airmen (who remain active duty) with (b) National Guard/Reservists (who train and then return to civilian life). This will allow a direct comparison of those who remain in the military environment versus those who return to the civilian sectors.