• Andrew J MacGregor, Amber L Dougherty, Zeina G Khodr, Jennifer McAnany, Cameron T McCabe, James M Zouris, Yohannes G Haile, and Lt Col Patricia Rohrbeck.
• Epidemiology and Data Management Support Department, Naval Health Research Center, San Diego, California, USA. Electronic address: andrew.j.macgregor.civ@health.mil.
• Am J Prev Med. 2024 Oct 28.

IntroductionU.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.MethodsData 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.ResultsThe 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.ConclusionsMultiple 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.Copyright © 2024. Published by Elsevier Inc.

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