Tobacco Use and Alcohol Misuse among Participants of the Millennium Cohort Study

描述（由申请人提供）：烟草和酒精滥用是美国的严重问题，在美国武装部队成员中更为普遍。这两种情况造成在服役期间和后来在平民生活期间较高的死亡率、较高的发病率、较高的保健费用和生产力损失。关于服兵役时养成这些习惯的预测因素的前瞻性研究信息很少。这些资料将证明对制定干预措施和政策以防止军事人员吸烟和酗酒很有价值。因此，本申请建议在千年队列研究中对兵役特征和暴露、人口特征以及吸烟和酗酒的心理社会风险因素进行全面的前瞻性评估，这是一项对15万多名军事人员进行的为期21年的纵向调查。这项研究于2001年开始招募美国武装部队成员。通过管理对国防部电子人员和保健数据库以及其他国家数据库的三年期调查和审查，对接触和结果的受试者进行后续跟踪。这项拟议研究的总体目标是确定服兵役期间接触烟草（包括无烟烟草）和酒精滥用的发生率、持久性和复发率的影响。这一目标将通过前瞻性研究这些结果与研究开始时和服兵役期间所经历的暴露有关来实现，例如有和没有战斗暴露的部署、其他军事暴露、心理健康状况、兵役特征和生活方式因素。此外，家庭千年队列研究将于2010年开始，届时将招募10,000名研究参与者的配偶。这种横断面比较将允许研究与前瞻性研究相同的预测因素，并允许首次评估服役人员的军事经历是否与配偶之间的吸烟和酗酒有关。

DESCRIPTION (provided by applicant): Tobacco and alcohol misuse are serious problems in the U.S. and are more prevalent among members of the U.S. Armed Forces. Both conditions account for higher mortality, greater morbidity, higher health care costs, and lost productivity while in the service and afterwards in civilian life. Little information exists from prospective research on predictors of the adoption of these habits while in military service. Such information would prove valuable for the development of interventions and policies for preventing tobacco use and alcohol misuse among military personnel. This application therefore proposes to conduct a comprehensive prospective assessment of military service features and exposures, demographic characteristics, and psychosocial risk factors for tobacco use and alcohol misuse in the Millennium Cohort Study, a 21-year longitudinal investigation of over 150,000 military personnel. This study began enrollment of members of the U.S. Armed Forces in 2001. Follow-up of subjects for both exposures and outcomes is accomplished through administration of a triennial survey and review of Department of Defense electronic personnel and health care databases as well as other national databases. The overall objective of this proposed research will be to identify the effects of exposures during military service on the incidence, persistence and relapse of tobacco use (including smokeless) and alcohol misuse. This objective will be accomplished by prospectively studying these outcomes in relation to exposures experienced at study entry and during military service, such as deployment with and without combat exposure, other military exposures, mental health conditions, military service characteristics and lifestyle factors. In addition, the Family Millennium Cohort Study will begin in 2010 when the spouses of 10,000 study participants will be recruited. This cross-sectional comparison will permit the study of the same predictors of interest as in the prospective study and allow for the first time the assessment of whether military experiences in the service member are associated with tobacco use and alcohol misuse among spouses.