Ethnic and gender differences in smoking and smoking cessation in a population of young adult air force recruits

Purpose. To examine gender and ethnic differences in smoking and smoking cessation in a population of young adult military, recruits. Design. A self-administered survey of demographics, tobacco use, and other health risk behaviors was administered at the start of basic military training. Setting. The study was conducted at Lackland Air Force Base, San Antonio, Texas, where all U.S. Air Force recruits complete basic military training. Subjects. All recruits who entered the U.S. Air Force between September 1995 and September 1996 participated in this study (n = 32,144; 100% participation rate). Measures. Recruits completed a written 53-item behavioral risk questionnaire. Measures examined in the present study included smoking status (ever having smoked a cigarette, current daily smoking, and quitting); demographics (ethnicity, gender, education, family, income, and age); smoking history; and nicotine dependence. Results. Rates of ever smoking, current daily smoking, and quitting were examined in multiple logistic regression analyses as a function of gender and ethnicity, controlling for age, education, and family income. Overall, 54% of recruits had ever smoked a cigarette and 24.9% smoked daily at the time of entry into basic military training. Smoking rates were highest among white and Native American recruits. Among whites, women were more likely to be a current daily smoker (31.6% vs. 29.4%; odds ratio [OR] = 1.18, 99% confidence intervals [CI] = 1.08-1.29). The opposite Pattern was observed among African-Americans (5.6% vs. 9.8%, respectively; OR = .57; CI = .41-.79). Current smokers had low levels of nicotine dependence compared with the general population of U.S. smokers, but whites tended to be more dependent than other ethnic groups. Cessation rates were similar for men and women but differed according to ethnicity, ranging from 15% among whites to 23% among Hispanics. Conclusions. These findings document important gender and ethnic differences in cigarette smoking among military recruits. Whites and Native Americans were more likely to smoke, less likely to quit, and more nicotine-dependent than other ethnic groups. Across gender/ethnicity groups, smoking rates were especially high among white women, with nearly one-third smoking daily until entry into basic training. Gender differences were not observed in cessation rates, but Hispanics were more likely than other ethnic groups to have quit smoking. The results highlight the need to develop effective cessation interventions for this population.