This paper examines the impact of the military population's changing demographic composition on observed changes in substance use by military personnel. Cross-sectional data are drawn from the six Department of Defense Worldwide Surveys of Substance Abuse and Health Behaviors Among Military Personnel conducted in 1980, 1982, 1985, 1988, 1992, and 1995. Using the method of direct standardization to adjust for changes in demographic composition, trends in substance use are examined. Changes in heavy alcohol use were more affected by demographic changes in the military population than were changes in illicit drug use or cigarette use. Findings indicate that changes in demographic composition may need to be controlled when assessing trends from cross-sectional surveys. [Translations are provided in the International Abstracts Section of this issue.]

This paper examines the relationship between perceived stress (at work, in family or personal life, and from being a woman in the military) and substance use (heavy drinking, illicit drug use, cigarette smoking) among active-duty military women and men. Data were drawn from over 16,000 respondents to the 1995 Department of Defense Survey of Health Related Behaviors Among Military Personnel. Findings indicated substantial substance use and perceived high stress in the armed forces. Further, the relation between substance use and stress varied by gender. Military women reported substantially lower rates of heavy drinking than men, but had similar rates of illicit drug use and cigarette smoking. Both military women and men were more likely to describe their military duties as more stressful than their family or personal lives; for women, the stress associated with being a woman in the military was second to stress at work. Stress at work or in the family was an important predictor of substance use among military men, but not among military women. For military women, stress associated with being a woman in the military was predictive of illicit drug use and cigarette use. These findings suggest that more effective stress management strategies may need to be implemented for military men to reduce the link between stress and heavy alcohol use, illicit drug use, and smoking.

This paper examines trends in alcohol use, illicit drug use, and cigarette use in the U.S. military. Data are drawn from five worldwide surveys (conducted in 1980, 1982, 1985, 1988, and 1992) of active-duty personnel. All surveys used similar methods and common measures of alcohol, illicit drug, and cigarette use. Findings indicate steady and notable reductions in overall alcohol consumption, illicit drug use, and cigarette use. They show less decrease in heavy alcohol use, however, and the apparent decline from 1980 to 1992 is largely a function of demographic changes in the military. In 1992, during the 30 days before the survey, about 1 in 3 personnel smoked, about 1 in 7 were heavy drinkers, and about 3 in 100 used illicit drugs; rates were higher among certain demographic subgroups. Further reductions in smoking and heavy drinking remain the major substance use challenges for the U.S. military in the 1990s.

BACKGROUND Using data from the military's Worldwide Survey series, this article presents findings on the prevalence of smoking among active-duty military personnel in 1992 and trends since 1980. METHODS A stratified probability sampling design was used in the 1992 Worldwide Survey. Military installations worldwide were sampled, and then active-duty personnel within these installations were selected. A total of 16,395 usable questionnaires were obtained, for an overall response rate of 77.3%. RESULTS The prevalence of cigarette smoking among military personnel has declined from 51% in 1980 to 35% in 1992. This decline was not explained by changes in the sociodemographic composition of the military population. Overall, smoking was more prevalent among personnel who were white, had less education, and were enlisted. In addition, enlisted men reporting higher levels of work-related stress were more likely to be smokers. Over half of all military personnel who were smokers in the past year attempted to quit. CONCLUSIONS The military has made considerable progress since 1980 in reducing the prevalence of smoking among military personnel. Nonetheless, the prevalence in 1992 was still relatively high, affecting about one of every three personnel. A promising group to target in future antismoking efforts may be smokers who tried to quit during the past year.

Since 1970, the Department of Defense has set forth a series of policies and programs to combat drug and alcohol abuse among military personnel. The goal of the current policy is one of zero tolerance toward drug and alcohol abuse. Programmatic areas to help attain this goal are assessment, deterrence and detection, treatment and rehabilitation, and education and training. Progress toward eliminating drug and alcohol abuse among military personnel is traced by examining efforts in each of these programmatic areas. The authors conclude that the dramatic decreases in drug use and more stable patterns of alcohol use since 1980 indicate that military policy and programs to eliminate drug abuse have been highly successful, but that military efforts to eliminate alcohol abuse should be intensified.

BACKGROUND:Understanding the effectiveness of policies and programs aimed at combating substance abuse in the military requires comparison with the civilian population from which military personnel are drawn.METHODS:Standardized comparisons of the use of alcohol, drugs, and cigarettes among military personnel and civilians were conducted with data from the 1985 Worldwide Survey of Alcohol and Nonmedical Drug Use among Military Personnel and the 1985 National Household Survey on Drug Abuse. The two data sets were equated for age and geographic location of respondents, and civilian substance use rates were standardized to reflect the sociodemographic distribution of the military.RESULTS:Military personnel were significantly less likely than civilians to use drugs, but were significantly more likely to use alcohol and cigarettes and to engage in heavy use of alcohol and cigarettes. Heavy drinking was especially likely among young military men. Military women were similar to military men in their smoking and drug use patterns.CONCLUSIONS:Findings suggest that military policies and programs have been notably effective in reducing drug use, but that efforts to limit alcohol and cigarette use should be intensified. Military efforts directed against alcohol abuse should be targeted toward younger men, while smoking and drug prevention programs should be directed toward both men and women.

This paper presents data on substance use by military personnel from a series of worldwide surveys conducted in 1985, 1982, and 1980 with primary emphasis on the 1985 survey. Estimates are based on responses from participants serving on active duty in the Army, Navy, Marine Corps, and Air Force. Results for 1985 indicate pervasive use of alcohol, substantial use of tobacco, and low nonmedical use of drugs among military personnel. Average daily consumption of alcohol declined significantly from 1.4 ounces in 1982 to 1.2 ounces in 1985, but the patterns of use remained relatively constant. Nonmedical drug use during the past 30 days declined significantly, from 27.0% in 1980, to 19.0% in 1982, to 8.9% in 1985. Cigarette smoking declined significantly from 51.4% in 1982 to 46.2% in 1985. Current alcohol and drug use is concentrated among younger, less educated, unmarried, and junior and mid-career enlisted personnel. Cigarette pack years are higher among males, whites, those with less than a high school education, and senior enlisted personnel. Results show progress in reducing drug use and smoking in the military, but little change in patterns of alcohol use. New initiatives and approaches by the military to further reduce substance abuse are discussed.

Drug-abuse treatment may have important direct and indirect effects on restricting the spread of infection with human immunodeficiency virus by decreasing the prevalence of intravenous drug use and by decreasing regular drug use that impairs the immune system. Drug-abuse treatment results in substantial declines in the use of heroin, cocaine, prescription psychotherapeutic drugs, and other drugs in the year after treatment. Declines are closely related to the length of time spent in treatment; treatment duration of greater than or equal to 6 months has a significant impact on drug use after treatment. The potential impact of drug-abuse treatment in combatting the AIDS epidemic is discussed.

The relationship between substance use (alcohol, drugs, and tobacco) and health (health practices, number of illnesses, number of physician visits, and days hospitalized) was examined using data from the 1985 Worldwide Survey of Alcohol and Nonmedical Drug Use Among Military Personnel. Substance users, particularly heavy users, were less likely than nonusers to engage in health practices and were more likely to experience illness, physician visits, and hospitalizations. Significant effects on the number of illnesses were observed for heavy drinkers compared with abstainers, drug users other than marijuana only users compared with nonusers, and those who smoked one or more packs of cigarettes per day compared with nonsmokers. The potential of substance use programs in improving health status and health promotion programs in reducing substance use among military personnel is discussed.