Publication year
2016
Citation Title
Deployment stress, tobacco use, and postdeployment posttraumatic stress disorder: Gender differences
Journal Name
Physical Trauma: Theory, Research, Practice, and Policy
Journal Volume
8
Issue Number
2
Page Numbers
123-126
DOI
10.1037/tra0000093
Summary
Increased numbers of women are being deployed to combat zones, yet little is known about their tobacco use and posttraumatic stress disorder (PTSD). Therefore, an examination of gender-specific associations between deployment stress, tobacco use, and post-deployment PTSD symptoms was completed.
Key Findings
Warfare stress was associated with initiation and increases in tobacco use during deployment in both men and women.
Harassment stress was associated with initiation and increases in tobacco use in women only.
Neither warfare exposure nor harassment exposure predicted continuation of tobacco use post-deployment
Continued tobacco use after deployment was associated with PTSD in women.
Implications for Program Leaders
Offer training before deployment on healthy means of coping with deployment stress (e.g., social support, relaxation, exercise, cognitive interventions) for Service members and families
Develop online modules for both male and female Service members on tobacco use and deployment, and harassment, tobacco use and deployment
Create support groups for Service members and their spouses upon their return from deployment to address issues of mental and physical health
Implications for Policy Makers
Recommend training for Service members on positive coping strategies or interventions to prevent or treat tobacco dependence
Encourage an awareness campaign that brings to light issues of military harassment and its effects on Service members and their families
Recommend professional development for professionals who work with military families around deployment stress and coping strategies
Methods
Participants were randomly selected from the Environmental Epidemiology Service’s roster of Operation Enduring Freedom/Operation Iraqi Freedom Veterans.
Measures on tobacco use, deployment stress, and PTSD symptoms were selected from a larger previous study.
Analyses on the associations between deployment stress, tobacco use during and after deployment, and post-deployment PTSD symptoms by gender were conducted.
Participants
Participants completed the survey on average 4.25 years after their most recent deployment.
The sample included 1,074 men and 1,139 women.
All military branches were represented, but the Army was the most common (men: 52%; women: 56%).
Participants’ ages, race and ethnicity were not provided.
Limitations
Self-reports of tobacco use and PTSD symptoms during deployment were given between 3 and 10 years later.
Data were drawn from a previous study; therefore, measures were not adaptable to the current study.
Participant’s current physical and psychological state, which was not measured, could have affected the outcomes of the study.
Avenues for Future Research
Employ a longitudinal design which could better assess the relationships between trauma exposure, PTSD, and tobacco use.
Investigate what biological or psychological mechanisms may be associated with increases in tobacco use in reaction to extreme stress.
Broaden the sample to include different ranks, education level, length of deployment, and type of combat to assess any differences in PTSD and tobacco use.
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: Epidemiological research has demonstrated that tobacco use and posttraumatic stress disorder (PTSD) frequently co-occur and are highly prevalent among Veterans; research with female Veterans is limited. Given the increasing numbers of women deployed to combat zones in recent conflicts, the objective of the current study was to examine gender-specific associations between deployment stress, tobacco use and postdeployment PTSD symptoms. Method: Two thousand thirteen Veterans deployed to Afghanistan and Iraq (50.9% female; mean age = 35.53) completed a postdeployment, mailed survey that assessed tobacco use before, during, and after deployment, deployment stressors, and postdeployment PTSD symptoms. Results: Warfare stress was associated with initiation and increases in tobacco use during deployment in both men and women, whereas harassment stress was associated with initiation and increases in tobacco use in women only. Only among women was continued postdeployment tobacco use associated with postdeployment PTSD symptoms. Conclusions: We found a dose-dependent relationship between deployment stress and adoption and escalation of tobacco use; the stressors that provoked initiation and escalation of tobacco use differed by gender. Continued tobacco use after deployment was associated with PTSD in women suggesting that women used tobacco more selectively than men to regulate negative affect. Implications of this work are that training before combat and during combat on healthy means of coping with deployment stress is needed to prevent tobacco use. For women, reducing harassment stress during deployment and early treatment of acute stress and PTSD during and soon after deployment may prevent intractable tobacco use.
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