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Correlates of e-cigarette use among active duty US military personnel: implications for cessation policy.

  • Godby, Sarah1
  • Dierst-Davies, R2
  • Kogut, D1
  • Degiorgi Winslow, L1
  • Truslow, M M1
  • Tuttle, J1
  • Koeppl, P1
  • Marshall-Aiyelawo, K3
  • Elenberg, K4
  • 1 Deloitte Consulting LLP, Arlington, Virginia, USA.
  • 2 Deloitte Consulting LLP, Arlington, Virginia, USA [email protected].
  • 3 Analytics and Evaluation Division (J-5), Defense Health Agency, Falls Church, Virginia, USA.
  • 4 Office of the Under Secretary for Personnel and Readiness, US Department of Defense, Washington, DC, USA.
Published Article
BMJ military health
Publication Date
Jun 01, 2023
DOI: 10.1136/bmjmilitary-2020-001700
PMID: 33664088


Electronic cigarette (or e-cigarette) use has grown substantially since its US market introduction in 2007. Although marketed as a safer alternative to traditional cigarettes, studies have shown they can also be a gateway to their use. The purpose of this investigation is to identify factors associated with different patterns of tobacco use among active duty military personnel. A secondary analysis was conducted using the 2014 Defense Health Agency Health Related Behaviors survey data. Results are based on 45 986 US military respondents, weighted to 1 251 606. Both univariate and regression analyses were conducted to identify correlates. In 2014, approximately 7.8% of respondents reported using e-cigarettes at least once in the past year. Among e-cigarette users, 49% reported exclusive e-cigarette use. Prevalence of exclusive use is highest among white people (58%), Navy (33%), men (83%) and persons with income ≤$45 000 (65%). Regression comparing exclusive cigarette with exclusive e-cigarette users revealed higher odds of being Air Force (OR=2.19; CI 1.18 to 4.06) or Navy (OR=2.25; CI 1.14 to 4.41) personnel and being male (OR=1.72; CI 1.12 to 2.64), and more likely to not receive smoking cessation messaging from healthcare providers in the last 12 months (OR=2.88; CI 1.80 to 4.62). When comparing exclusive e-cigarette users with poly-tobacco users, e-cigarette users had higher odds of being Hispanic (OR=2.20; CI 1.02 to 4.78), college educated (OR=4.25; CI 1.22 to 14.84) and not receiving tobacco prevention/cessation messaging (OR=4.80; CI 2.79 to 8.27). The results demonstrate that exclusive e-cigarette users in the military have unique characteristics when compared with groups of other/mixed tobacco users. Findings can inform cessation and prevention efforts to improve both the overall health and combat readiness of active duty military personnel. © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

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