Comparing tobacco use among incoming recruits and military personnel on active duty in the United States.

OBJECTIVE To compare the tobacco use profile of recruits with that of military personnel on active duty to determine whether the military environment in some way induces service members to initiate tobacco use. DESIGN AND SETTING Cross-sectional survey of United States armed forces active duty and recruit personnel in 1994-95. SUBJECTS 2711 military recruits and 4603 military personnel on active duty. MAIN OUTCOME MEASURES Comparative cigarette smoking and smokeless tobacco use prevalence between recruits and personnel on active duty controlling for age, sex, and race. Impact of demographic factors on the odds of smoking or using smokeless tobacco. RESULTS Increases in tobacco use in American military personnel occurred exclusively in men. The highest tobacco use resided with white men on active duty (43% cigarette smoking; 24% smokeless tobacco use) and represents a doubling of tobacco use seen among white male recruits. Among non-white men, tobacco use increased 2-4 times between recruits and personnel on active duty. CONCLUSIONS Efforts to reduce tobacco use by American military personnel on active duty should focus more on discouraging the initiation of tobacco use.