Veteran-nonveteran differences in alcohol and drug misuse by tobacco use status in Alabama SBIRT

Alcohol and substance use can challenge military veterans who live in rural communities. In 2016, the screening, brief intervention, and referral to treatment in Alabama (AL-SBIRT) program was implemented in west Alabama. The primary aim of this study was to determine whether current tobacco use modified the relationship between veteran status and substance misuse. Self-reported wellness data was collected regarding substance, alcohol, or tobacco consumption. Risk levels for alcohol and drug use were measured using the United States Alcohol Use Disorders Identification Test (US-AUDIT) and the Drug Abuse Screening Test (DAST)-10. Substance and tobacco use were significantly and positively correlated. Veterans had a higher US-AUDIT and DAST score than nonveterans, and tobacco appeared to be an exacerbating factor. Effective evidence-based interventions are needed in rural settings. Technology based programs and motivational interviewing with trained clinicians may serve as beneficial and cost-effective interventions for tobacco use prevention and cessation efforts.