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。这两种情况都造成了较高的死亡率、较高的发病率、较高的保健费用以及在服役期间和之后的平民生活中的生产力损失。很少有信息存在的前瞻性研究预测通过这些习惯，而在服兵役。这类信息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、人口统计学特征以及烟草使用和酒精滥用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21年纵向调查。这项研究于2001年开始招募美国武装部队成员。通过对国防部电子人员和医疗保健数据库以及其他国家数据库进行三年一次的调查和审查，完成对受试者暴露和结局的随访。这项拟议研究的总体目标是确定服兵役期间暴露对烟草使用（包括无烟烟草）和酒精滥用的发生率、持续性和复发的影响。这一目标将通过前瞻性研究这些结果与研究入组时和服役期间经历的暴露（如有和无战斗暴露的部署、其他军事暴露、心理健康状况、服役特征和生活方式因素）的相关性来实现。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中相同的感兴趣的预测因子，并首次允许评估服役人员的军事经历是否与配偶之间的烟草使用和酒精滥用有关。 公共卫生相关性：该研究将研究兵役特征和经验作为参与千年队列研究的美国军人采用烟草使用和酒精滥用发生的预测因素。将研究军事部署，生活方式，心理健康状况和兵役特征的作用。更好地了解采取这些习惯之前的因素可能会导致更好的方法，以帮助防止烟草使用和酒精滥用发生在这一人群中。

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. PUBLIC HEALTH RELEVANCE: The research will examine military service features and experiences as predictors of the adoption of tobacco use and the occurrence of alcohol misuse in U.S. military service members enrolled in the Millennium Cohort Study. The roles of military deployments, lifestyle, mental health conditions, and military service characteristics will be studied. A better understanding of the factors that precede the adoption of these habits may lead to improved ways to help prevent tobacco use and alcohol misuse from occurring in this population.