Cigarette use and injury risk among US army soldiers

Prior tobacco use is a consistent injury risk factor among U.S. Army soldiers during basic training, but less is known about injury risk and tobacco use among soldiers beyond basic training. Purpose: To describe cigarette use and injury risk among soldiers in an infantry brigade. Methods: Demographics, tobacco use, and Army physical fitness test (APFT) results were obtained by survey. Injury-related medical encounter data were obtained from the Defense Medical Surveillance System. Current cigarette smokers were those who had smoked more than 100 cigarettes in their lifetime and at least one cigarette in the past month. Odds of injury (OR) and 95% confidence intervals (95%CI) from multivariable analysis are reported. Results: Of the 1,393 Soldiers surveyed, 46% (n=578) of men and 32% (n=47) of women reported current smoking. Among male smokers, 79% were <30 years old, 17% smoked ≥20 cigarettes per day, 35% had started smoking at age ≤14, and 45% also reported smokeless tobacco use. Among female smokers, 85% were <30 years old, 11% smoked ≥20 per day, 24% had started smoking at age ≤14, and 4% also reported smokeless tobacco use. Male smokers had 1.5 times greater injury risk compared to non-smokers (95%CI:1.2-1.9), controlling for other known risk factors; data were not sufficient to assess smoking and injury risk among females. Conclusion: In this young, employed population, cigarette use is common and injury risk was elevated among male smokers. Results will help focus prevention programs and serve as a reminder of a more immediate, potentially career-influencing adverse outcome.