Retrospective Cohort Study of Tobacco use and Outpatient Clinic Visits in a Military Population

摘要

Approximately sixty million Americans, almost thirty percent of the adult population, use tobacco products. Tobacco use is estimated to cause 6-12% of total medical expenditures in the United States, and is generally regarded as the most important avoidable health risk behavior in this population. Tobacco is a problem of similar magnitude in the United States military and is the focus of local and national efforts to reduce tobacco use in this population. Causal links between tobacco use and chronic illnesses, especially respiratory cardiovascular, and malignant disease, are well established. Effects of tobacco on young healthy populations with non-chronic diseases are less well studied. This retrospective cohort study described the relationships between tobacco use and the thirty most common disease categories in an active duty Air Force population. It controlled for age, sex, race, rank, body mass index, and performance on a fitness test in two exposure groups defined by self identified tobacco use. Regression modeling was used to define odds ratios and confidence intervals which could approximate the relative risk that tobacco use represented in this population. Tobacco use was expected to be related to an increased utilization of outpatient medical care for conditions where tobacco use was either causally or co-morbidly related, and show no increase in groups of diseases where tobacco use has not been associated. Results of the study were mixed.