Introduction: Although there is increasing attention to the prevalence of new and emerging tobacco products in the civilian population, remarkably little is known about the current prevalence of these products in a military population. Methods: The current investigation was designed to determine the prevalence of tobacco and nicotine containing products (TNCP) and correlates of use across multiple cohorts of trainees undergoing Technical Training in the US Air Force between April 2013 and December 2014. Chi-square test, Cochran–Armitage test for linear trend, and logistic regression models were applied to test differences and linear trends across time for TNCP use as well as correlates of use in a cross-sectional sample of 13 685 Airmen (final analytic sample). Results: Over a quarter (26.9%) of Airmen reported regular use of a TNCP. The two most prevalent products were cigarettes (11.2%) and hookah (10.5%). Among correlates of use, Airmen that regularly use TNCPs were more likely to be male, younger, non-Hispanic white, and single with a high school degree or General Education Development. Hookah was the most endorsed for intentions to use, and along with e-cigarettes, had the lowest perception of harm. While prevalence of most products remained constant across entering cohorts, the prevalence of e-cigarettes showed significant linear increase. Conclusions: The prevalence of TNCP use is high across cohorts of Airmen. Remarkably high estimates of future intentions to use and low perceptions of harm for emerging products suggest that intervention efforts should be directed at multiple forms of TNCP use to address this important public health issue.

The present investigation was designed to determine the prevalence and types of dual and poly-use of tobacco products in the US Air Force, as well as characteristics and factors associated with these types. We conducted a cross-sectional assessment of tobacco-product use among 13,873 Air Force trainees from 2013 to 2014. The assessment included prevalence of the use of 10 different tobacco products and demographic and environmental factors, such as risk perceptions of tobacco use, peer use, and tobacco-company influences. Latent class analysis was carried out to determine types of poly-tobacco users. Tobacco-product use was reported by 27.1% of participants, and of those, over half reported using more than 1 tobacco product. Latent class analysis indicated 5 classes of poly-tobacco use. Factors associated with poly-tobacco (vs. mono-tobacco) use included lower confidence to remain tobacco-free, low harm perceptions, and receiving tobacco products free at bars or social events. Rates of dual and poly-tobacco use are high among trainees, and while these groups are similar to mono users in some ways, there are a number of differences that need to be considered when developing targeted interventions to address use of multiple tobacco products.

Background: The US military has historically higher tobacco use compared to civilians, and tobacco use increases following enlistment. While the military is vulnerable to tobacco use, current surveillance of tobacco among this high-risk population is lacking. Methods: Recently enlisted Airmen (N = 43,597) between 2013 and 2018 were asked about tobacco use prior to enlistment across ten products: (1) cigarettes/roll your own tobacco, (2) smokeless tobacco/snus, (3) cigars, cigarillos/little cigars, (4) hookah/pipe, and (5) e-cigarettes. Results: Hookah/pipe use, cigarettes/roll your own, smokeless tobacco/snus, and cigars/little cigars/cigarillos use decreased significantly between 2013 and 2018, while the prevalence of e-cigarette use increased (p’s < 0.0001). The relationships between the time and each tobacco product(s) use outcomes were influenced differently by different age, race, education and marital status. Conclusion: While e-cigarette use has increased in the civilian sector, the use of e-cigarettes among new recruits increased much more drastically (i.e. prevalence 15.3% in 2018). Further, demographic characteristics influenced tobacco trends; specifically, recruits of racial minorities increased their use of e-cigarettes over the past five years faster than Whites. Of concern is what impact this dramatic increase in e-cigarette use will have on overall health and later initiation of combustible tobacco products in the military.

Introduction: While effective Brief Tobacco Interventions (BTIs) are available for cigarette smoking and smokeless tobacco, given the changing prevalence of tobacco and nicotine containing products (TNCPs), there is a need for interventions targeting a broader range of TNCPs (eg, cigarettes, smokeless tobacco, electronic cigarettes, and hookah). The purpose of the current investigation was to evaluate the efficacy of a BTI, a 40-minute intervention designed to intervene on four TNCPs in a sample of US military personnel during an 11-week period of involuntary tobacco abstinence, for reducing intentions to use TNCPs and increasing perceptions of harm of TNCPs. Methods: The BTI was administered to 1055 Airmen enrolled in Technical Training in the US Air Force. Assessments of perceived harm and intentions to use nine TNCPs (cigarettes, smokeless tobacco, snus, cigars, cigarillos, pipe, e-cigarettes, roll your own cigarettes, and hookah), were assessed at pretest and posttest (immediately following the BTI). Results: Significant increases in perceived harm were observed across all nine TNCPs (all P < .0001) for both users and nonusers. Intentions to use TNCPs were significantly reduced for most products but mainly among users. Conclusions: Results suggested that a BTI shows promise for impacting TNCP use in a military population. Further research should evaluate the behavioral outcomes (tobacco use) as a result of the intervention. Implications: Given that there are 220 000 new trainees in the military every year, the public health implications of an effective BTI targeting the most commonly used TNCPs for military trainees is considerable.