Correlates of e-cigarette use among active duty US military personnel: implications for cessation policy.

BACKGROUND: Electronic cigarette (or e-cigarette) use has grown substantially since its US market introduction in 2007. Although marketed as a safer alternative to traditional cigarettes, studies have shown they can also be a gateway to their use. The purpose of this investigation is to identify factors associated with different patterns of tobacco use among active duty military personnel. METHODS: A secondary analysis was conducted using the 2014 Defense Health Agency Health Related Behaviors survey data. Results are based on 45 986 US military respondents, weighted to 1 251 606. Both univariate and regression analyses were conducted to identify correlates. RESULTS: In 2014, approximately 7.8% of respondents reported using e-cigarettes at least once in the past year. Among e-cigarette users, 49% reported exclusive e-cigarette use. Prevalence of exclusive use is highest among white people (58%), Navy (33%), men (83%) and persons with income ≤$45 000 (65%). Regression comparing exclusive cigarette with exclusive e-cigarette users revealed higher odds of being Air Force (OR=2.19; CI 1.18 to 4.06) or Navy (OR=2.25; CI 1.14 to 4.41) personnel and being male (OR=1.72; CI 1.12 to 2.64), and more likely to not receive smoking cessation messaging from healthcare providers in the last 12 months (OR=2.88; CI 1.80 to 4.62). When comparing exclusive e-cigarette users with poly-tobacco users, e-cigarette users had higher odds of being Hispanic (OR=2.20; CI 1.02 to 4.78), college educated (OR=4.25; CI 1.22 to 14.84) and not receiving tobacco prevention/cessation messaging (OR=4.80; CI 2.79 to 8.27). CONCLUSION: The results demonstrate that exclusive e-cigarette users in the military have unique characteristics when compared with groups of other/mixed tobacco users. Findings can inform cessation and prevention efforts to improve both the overall health and combat readiness of active duty military personnel.

Development of an expert system knowledge base: a novel approach to promote guideline congruent asthma care.

Existing guidelines for the clinical management of asthma provide a good framework for such tasks as diagnosing asthma, determining severity, and prescribing pharmacological treatment. Guidance is less explicit, however, about establishing a patient-provider partnership and overcoming barriers to asthma management by patients in a way that can be easily adopted in clinical practice. We report herein the first developmental phase of the "Stop Asthma" expert system. We describe the establishment of a knowledge base related to both the clinical management of asthma and the enhancement of patient and family self-management (including environmental management). The resultant knowledge base comprises 142 multilayered decision rules that describe clinical and behavioral management in three domains: 1) determination of asthma severity and control; 2) pharmacotherapy, including prescription of medicine for chronic maintenance, acute exacerbation, exercise pretreatment, and rhinitis relief; and 3) patient self-management, including the process of intervening to facilitate the patient's asthma medication management, environmental control, and well-visit scheduling. The knowledge base provides a systematic and accessible approach for intervening with family asthma-related behaviors.

The influence of weight reduction and exercise regimes upon the personality profiles of overweight males.

In the present study, the MMPI was used to detect personality changes in 53 overweight, yet otherwise healthy, males who were participating in either a weight reduction or an aerobic exercise conditioning program. Analysis of pre- and post-intervention scores revealed that only the participants in the aerobic conditioning group demonstrated the predicted desirable psychological changes. More specifically, this group displayed significant clinically desirable changes on the Hs, PD, and HEA scores. Similar to the weight loss participants, a demographically matched nonintervention comparison group showed none of these desirable changes and actually yielded a significant increase on the D scale. However, when compared to this "normal" group, both intervention programs showed statistically significant differences on at least two MMPI scales.

The MMPI: regional difference or normal aging?

The Minnesota Multiphasic Personality Inventory (MMPI) is currently undergoing a process of revision and renormalization. Of particular concern is whether or not there is a need to develop separate normative tables for elderly subjects. Colligan, Osborne, Swenson, & Offord (1983) tested a large group of healthy subjects who ranged in age from 18 through 99. Their investigation uncovered numerous significant relationships between test taker age and scores on various scales of the MMPI. The present study looked at the MMPI profiles of 214 healthy men and women between the ages of 39 and 89. The results gleaned from this investigation do not reflect the same intensity of age-related changes that are reported by Colligan et al. (1983) and other similar studies. More specifically, we were unable to detect the age-related elevations in the "neurotic triad" (Hs, D, Hy scales) that have often been cited by other researchers. Additionally, we were not able to support the typically reported aging effects in scales Mf, Pa, Pt, and Si. We suggest that these and other similar differences may be attributed to geographic, societal, and population factors.