Rates of tobacco use are high among U.S. military personnel, including newly enlisted Airmen[1]. Airmen are required to abstain from tobacco use during basic military training and the first four weeks of technical training. Once the tobacco ban is lifted, many Airmen return to tobacco use and some initiate tobacco use for the first time. This week, ASHES reviews a study by Kathleen J. Porter and colleagues that examined the different factors that facilitate and/or deter tobacco use among newly enlisted Airmen in technical training.
What was the research question?
What personal, interpersonal, and environmental factors facilitate and deter tobacco use among Airmen in technical training?
What did the researchers do?
The researchers conducted 22 focus groups with 164 newly enlisted Airmen, Military Training Leaders, and Technical Training Instructors from the five largest Air Force technical training schools in the U.S. Participants were asked about their personal experience with tobacco and perceived facilitators and barriers to tobacco use for Airmen during technical training. From the focus group transcripts, the researchers identified factors that facilitate or deter tobacco use among Airmen. These factors were categorized as personal, interpersonal (i.e., related to the individual’s social network), and environmental.
What did they find?
Participants identified five personal-level factors that influence tobacco use among Airmen in technical training, including tobacco’s association with military job outcomes and health outcomes (see Figure). Participants also identified three interpersonal factors (peer influence, leadership influence, and normative beliefs) and two environmental factors (pricing and promotion and access to tobacco) that could influence tobacco use. All but one factor (normative beliefs) had aspects that both facilitate and deter tobacco use. For example, with regards to military job outcomes, participants shared that tobacco use helped with concentration during work (facilitator) but also interfered with work-related responsibilities, like potentially impacting performance on physical training tests (deterrent). Normative beliefs was the only factor that participants identified exclusively as a facilitator of tobacco use — many participants shared the perception that they could get away with tobacco use and that it was acceptable as long as strategies were used to conceal use.
Figure. Personal, interpersonal, and environmental factors that facilitate and deter tobacco use among Airmen in technical training. All factors have aspects that both facilitate and deter tobacco use, except for normative beliefs which is only viewed as a facilitator. Some Airmen viewed the cost of tobacco as reasonable while others viewed it as unreasonable. Click image to enlarge.
Why do these findings matter?
This study identified personal, interpersonal, and environmental factors that facilitate and deter tobacco use among Airmen during technical training. Programs and policies to prevent tobacco use and support tobacco cessation among Air Force personnel should target these factors at all levels. Anti-tobacco messaging could focus on the negative impacts that tobacco use can have on military performance and health outcomes, which Airmen have identified as deterrents to tobacco use. Many Airmen perceive tobacco use as acceptable outside of designated places and situations. Messaging should reinforce Air Force policy on tobacco use and the unacceptability of breaking these policies. Finally, periods of restriction on tobacco use might not result in long-term abstinence and might inadvertently encourage users to seek out ways to conceal use. Tobacco interventions and cessation services should be provided in conjunction with the restrictions on tobacco use to promote abstinence and prevent reinitiation.
Every study has limitations. What are the limitations of this study?
Participants were members of the Air Force participating or involved in technical training. Findings pertain to tobacco use among newly enlisted Airmen in technical training and may not be generalizable to other branches of the military or Airmen in other environments or situations (e.g., overseas deployment).
For more information:
SmokeFree offers tools and tips for quitting and maintaining abstinence from smoking tobacco. The Centers for Disease Control and Prevention also provides research and tips about cigarettes and how to quit. For additional self-help tools, please visit the BASIS Addiction Resources page.
— Kira Landauer, MPH
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[1] “Airmen” is a legacy term that refers to all individuals in the U.S. Air Force, including women and gender-nonconforming persons.