Publication year
2017
Citation Title
Patterns of smoking and unhealthy alcohol use following sexual trauma among U.S. Service members.
Journal Name
Journal of Traumatic Stress
Page Numbers
1-10
DOI
10.1002/jts.22214
Summary
Sexual assault and sexual harassment may potentially lead to unhealthy cigarette and alcohol use. This longitudinal study had 48,287 Service members report on their experiences of sexual trauma, smoking, and alcohol use (both initiation and relapse). Each participant was assessed at baseline and three or more years after. Results revealed that sexual assault increased the risk of smoking relapse for male Service members and alcohol relapse for female Service members.
Key Findings
Male Service members who experienced sexual assault while in the military were six times more likely to have smoking relapse than their counterparts who experienced no sexual assault.
Female Service members who experienced sexual assault while in the military were twice more likely to have alcohol relapse than females who did not.
The experience of sexual assault while in the military was not related to male or female Service members' initiation of unhealthy alcohol use.
Implications for Program Leaders
Develop workshops for new Service members on what to do if they experienced sexual assault in the military
Offer support groups for Service members who experienced sexual trauma so that they have a secure environment to communicate and support each other
Disseminate information regarding healthy ways to cope with stress or trauma
Implications for Policy Makers
Continue to promote programs that focus on the prevention, detection, and intervention of sexual assault and sexual harassment in the military
Encourage training for professionals working with Service members about the relationship between sexual assault and unhealthy behaviors
Raise awareness campaign in the military regarding ways of preventing sexual assault and the importance of building a safe environment for all Service members
Methods
Data were obtained from the Millennium Cohort Study (2001-2012); participants of the study had to be in the military at baseline and had to complete at least one follow-up questionnaire.
Measures included in this study assessed alcohol use (problem drinking, risky drinking, and unhealthy alcohol use), smoking (smoking history and smoking relapse), and sexual trauma (sexual harassment and sexual assault).
Data were analyzed to examine the relationship between sexual trauma at baseline and unhealthy behaviors (alcohol initiation, alcohol relapse, smoking relapse) at three-year follow-up.
Participants
Participants were 48,287 Service members who completed both the study baseline and study follow-up.
There were three sub-samples of participants: no history of unhealthy alcohol use at baseline (8,459 males and 4,816 females), with history of unhealthy alcohol at baseline (3,487 males and 1,318 females), and former smokers (4.610 males and 1,453 females); the average age of participants was not reported.
The majority of participants were White, followed by Black and others; the specific percentages of each race/ethnicity were not reported. The military branches of participants were not reported.
Limitations
The sexual trauma information was assessed with only two questions which may not fully capture Service members' sexual trauma experiences.
There was a three-year span between baseline and follow-up assessment, which means that some unhealthy alcohol and cigarette use may have already been resolved during the three years; therefore, the follow-up assessment may not fully capture participants' unhealthy behaviors after a sexual trauma.
The study was based merely on self-report data, so the results of the study may be subject to memory bias or social desirability bias.
Avenues for Future Research
Assess sexual trauma by collecting more comprehensive data, especially information regarding specific behaviors (e.g., unwanted touch)
Shorten the time interval between the baseline assessment and follow-up assessments so that potentially more unhealthy behaviors after sexual trauma can be captured
Examine how military rank may influence the relationship between sexual trauma and unhealthy behaviors
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
In the first known longitudinal study of the topic, we examined whether experiencing sexual assault or sexual harassment while in the military was associated with increased risk for subsequent unhealthy alcohol use and smoking among U.S. service members in the
Millennium Cohort Study (2001–2012). Adjusted complementary log–log models were fit to estimate the relative risk of (a) smoking
relapse among former smokers (men: n = 4,610; women: n = 1,453); (b) initiation of unhealthy alcohol use (problem drinking and/or
drinking over recommended limits) among those with no known history of unhealthy alcohol use (men: n = 8,459; women: n = 4,816); and (c) relapse among those previously reporting unhealthy alcohol use (men: n = 3,487; women: n = 1,318). Men who reported experiencing sexual assault while in the military had sixfold higher risk for smoking relapse: relative risk (RR) = 6.62; 95% confidence interval (CI) [2.34, 18.73], than men who did not. Women who reported experiencing sexual assault while in the military had almost twice the risk for alcohol relapse: RR = 1.73; 95% CI [1.06, 2.83]. There were no other significant associations. These findings suggest that men and women may respond differently following sexual trauma, and support future concerted policy efforts by military leadership to prevent, detect, and intervene on sexual assault.
Millennium Cohort Study (2001–2012). Adjusted complementary log–log models were fit to estimate the relative risk of (a) smoking
relapse among former smokers (men: n = 4,610; women: n = 1,453); (b) initiation of unhealthy alcohol use (problem drinking and/or
drinking over recommended limits) among those with no known history of unhealthy alcohol use (men: n = 8,459; women: n = 4,816); and (c) relapse among those previously reporting unhealthy alcohol use (men: n = 3,487; women: n = 1,318). Men who reported experiencing sexual assault while in the military had sixfold higher risk for smoking relapse: relative risk (RR) = 6.62; 95% confidence interval (CI) [2.34, 18.73], than men who did not. Women who reported experiencing sexual assault while in the military had almost twice the risk for alcohol relapse: RR = 1.73; 95% CI [1.06, 2.83]. There were no other significant associations. These findings suggest that men and women may respond differently following sexual trauma, and support future concerted policy efforts by military leadership to prevent, detect, and intervene on sexual assault.
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