Substance use and misuse in the Croatian Army Special Forces: prevalence and influencing factors.

Objectives: In addition to being a serious health-hazard, substance-use-and-misuse (SUM) in military forces negatively influences physical fitness and army readiness. The aim of this study was to define the prevalence of SUM, which includes cigarette smoking, alcohol consumption, and multiple SUM (i.e. practice of daily smoking and harmful alcohol drinking), and factors influencing SUM in the Croatian Special Army Forces (SAF).

Materials And Methods: We studied 73 SAF members. A self-administered validated questionnaire was used to gather socio-demographic and military-profession-related data, and SUM factors. The associations between studied variables were established by the Chi2 test, and forward conditional logistic regression (FCLR).

Results: With less than 40% of daily smokers, smoking was within expected values. Almost 80% of the examinees reported no binge drinking, while 54% reported harmful drinking according to the Alcohol Use Disorders Identification Test scale. Paternity and education level were negatively associated with daily smoking, while higher incidence of daily smoking was found for privates and those who practiced harmful drinking (all at p < 0.05). The FCLR demonstrated a higher risk of harmful alcohol consumption for younger commissioned officers (OR for military rank = 5.54, 95% CI: 2.19-13.99; OR for age = 0.85, 95% CI: 0.76-0.95).

Conclusion: Although SUM incidence was not alarming compared to the overall population and the previously reported military data, additional efforts are necessary in order to decrease cigarette consumption. The study showed that protective/risk structure of the substance misuse in the military should be investigated specifically with regard to particular military services, corps, and socio-cultural environment.