Prevalence and Correlates of Tobacco Smoking in the Sri Lanka Army

Abstract

Introduction: All service personnel are expected to be psychologically and physically healthy. However, certain behaviours may impede the above, and tobacco smoking is one out of many. Studies reiterate the high prevalence of smoking in the military, and the military culture, low education, younger age, psychiatric conditions childhood adversities, and alcohol and substance use are implicated. Methodology: This was a retrospective cross-sectional study, done in the Army Security Force Headquarters East, in a sample of 147 Officers and 3519 Other Ranks (ORs), serving > 2 years. A self-administered questionnaire inquired into demographic data, probable depression, high-risk drinking, symptoms of PTSD, symptoms of fatigue, cannabis use, childhood adversities, aggression, and cohesion. Smoking experience was assessed in terms of never, past and current use. The adjusted Odds Ratio determined the significance of the correlates of smoking. Results: Fifty point nine percent (95% CI 49.4% - 52.6%) were current smokers and 62.4% (95% CI 60.8%-64.0%) smoked in the past. Younger age, lower education, marriage, longer service, cannabis use and high-risk drinking were significantly associated with current and past smoking behaviours. Discussion: Compared to community surveys, smoking is high within the Army. Younger age, lower education, and lower rank were demographic covariates, which could be due to the inability to cope with stress and the military environment (i.e. due to the availability and the social influence). Alcohol and cannabis complement the effects of smoking. Depression and fatigue could be outcomes or causes of smoking. Health education and stress management programmes and imposing smoking restrictions within military installations are recommended to dissuade smoking in the Army.

Keywords

• smoking tobacco
• high-risk drinking
• cannabis use
• army