Pre-Service Predictors of New-Onset Alcohol Misuse in Male United States Marines

Andrew J MacGregor; Amber L Dougherty; Zeina G Khodr; Jennifer McAnany; Cameron T McCabe; James M Zouris; Yohannes G Haile; Patricia Rohrbeck

doi:10.1016/j.amepre.2024.10.016

Pre-Service Predictors of New-Onset Alcohol Misuse in Male United States Marines

Am J Prev Med. 2024 Oct 28:S0749-3797(24)00368-4. doi: 10.1016/j.amepre.2024.10.016. Online ahead of print.

Authors

Andrew J MacGregor¹, Amber L Dougherty², Zeina G Khodr³, Jennifer McAnany³, Cameron T McCabe², James M Zouris⁴, Yohannes G Haile³, Patricia Rohrbeck⁵

Affiliations

¹ Epidemiology and Data Management Support Department, Naval Health Research Center, San Diego, California. Electronic address: andrew.j.macgregor.civ@health.mil.
² Epidemiology and Data Management Support Department, Naval Health Research Center, San Diego, California; Leidos, Inc., San Diego, California.
³ Deployment Health Department, Naval Health Research Center, San Diego, California; Leidos, Inc., San Diego, California.
⁴ Epidemiology and Data Management Support Department, Naval Health Research Center, San Diego, California.
⁵ Military Population Health Directorate, Naval Health Research Center, San Diego, California.

PMID: 39477132
DOI: 10.1016/j.amepre.2024.10.016

Abstract

Introduction: U.S. military personnel have a high prevalence of alcohol misuse, which can adversely affect force readiness. The objective of this study was to identify pre-service predictors of new-onset alcohol misuse among male Marines.

Methods: Data for this retrospective cohort study were collected from male U.S. Marines who completed a baseline survey at the beginning of military training from 2013 to 2021 and a standard health assessment 12-36 months later (n=28,337). An Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) score ≥4 indicated alcohol misuse. Independent predictors of alcohol misuse were evaluated using a modified Poisson regression to calculate adjusted risk ratios (aRRs) and 95% CIs. Analyses were conducted between 2022 and 2024.

Results: The incidence of new-onset alcohol misuse was 16.3% (n=4,632). In the final multivariable model, the strongest predictor of new-onset alcohol misuse was turning 21 years old during the study period (aRR=3.70; 95% CI=3.40, 4.03). Pre-service tobacco use (aRR=1.32; 95% CI=1.22, 1.43) and some pre-service alcohol use (AUDIT-C score 1-3: aRR=1.32; 95% CI=1.24, 1.40) were also associated with new-onset alcohol misuse.

Conclusions: Multiple pre-service predictors were associated with new-onset alcohol misuse in male Marines. These findings should be considered when screening for alcohol misuse and developing clinical interventions to mitigate adverse impacts of alcohol misuse in the military.