Abstract
Objectives
Firefighters play a crucial role in protecting the lives and property of the communities
they serve. Health and readiness for duty among women firefighters is of great concern
because they are a significantly understudied group in this critical occupation. A
tobacco-free fire service has been strongly promoted, but there are no published data
on the extent and types of tobacco use among women firefighters.
Methods
Data were collected as part of a national online study of the health of women in the
fire service.
Results
A total of 1,712 women firefighters completed questions regarding tobacco use. Unadjusted
smoking and smokeless tobacco rates were 5.1% and 1.2%, respectively. Age standardized
smoking rates were lower than those of male firefighters and U.S. adult women. Smokeless
tobacco use prevalence was very low compared with male firefighters, but comparable
with U.S. adult women. Tobacco users were more likely to have lower education and
income and were younger when compared with those who did not use tobacco. There was
a strong association between tobacco use and problem and binge drinking.
Conclusions
Current findings suggest that the rates of cigarette and smokeless tobacco use are
relatively low among women firefighters. Unhealthy lifestyle behaviors such as problem
and binge drinking were strongly associated with tobacco use.
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References
- Screening for depression in well older adults: Evaluation of a short form of the CES-D.American Journal of Preventive Medicine. 1994; 10: 77-84
- Brief screening instrument for post-traumatic stress disorder.British Journal of Psychiatry. 2002; 181: 158-162
- Alcohol and tobacco use patterns among heterosexually and homosexually experienced California women.Drug and Alcohol Dependence. 2005; 77: 61-70
- Women and smoking: A report of the Surgeon General.(Available:)
- The health consequences of smoking – 50 years of progress: A report of the Surgeon General.(Available:)www.surgeongeneral.gov/library/reports/50-years-of-progressDate: 2014Date accessed: October 12, 2018
- Behavioral risk factor surveillance system questionnaire.(Available:)www.cdc.gov/brfss/questionnaires/pdf-ques/2018_BRFSS_English_Questionnaire.pdfDate: 2018Date accessed: October 10, 2018
- The accuracy of self-reported smoking: A systematic review of the relationship between self-reported and cotinine-assessed smoking status.Nicotine & Tobacco Research. 2009; 11: 12-24
- Relationship between smoking and obesity: A cross-sectional study of 499,504 middle-aged adults in the UK general population.PLoS One. 2015; 10: e0123579
- Relationship of health related quality of life to health care utilization and mortality among older adults.Aging Clinical and Experimental Research. 2002; 14: 499-508
- An epidemiologic analysis of co-occurring alcohol and tobacco use and disorders: Findings from the national epidemiologic survey on alcohol and related conditions.Alcohol Research & Health. 2008; 31: 100-110
- International association of firefighters diversity initiative: Achieving and retaining a diverse fire service workforce.(Available:)
- Tobacco use among firefighters in the Central United States.American Journal of Industrial Medicine. 2011; 54: 697-706
- Alcohol use and problem drinking among women firefighters.Womens Health Issues. 2017; 27: 632-638
- The validity of self-rated health as a measure of health status among young military personnel: Evidence from a cross-sectional survey.Health and Quality of Life Outcomes. 2006; 4: 57
- The combined effect of smoking tobacco and drinking alcohol on cause-specific mortality: A 30 year cohort study.BMC Public Health. 2010; 10: 789
- US fire department profile 2015.(Available:)www.nfpa.org/-/media/Files/News-and-Research/Fire-statistics-and-reports/Emergency-responders/osfdprofile.pdfDate: 2017Date accessed: October 12, 2018
- Epidemiology in medicine.Lippincott Williams & Wilkins, Philadelphia, PA1987
- Socioeconomic status and women’s smoking behavior: A literature review.Global Journal of Health Science. 2011; 3: 98-103
- A national report card on women in firefighting.(Available:)
- Campaign for a smoke-free union.(Available:)
- Screening for depression in the older adult: Criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D).Archives of Internal Medicine. 1999; 159: 1701-1704
- Understanding exercise for health and fitness.3rd ed. Kendall/Hunt, Dubuque, IA1997
- The health of women in the US fire service.BMC Women’s Health. 2012; 12: 39
- Health concerns of the U.S. fire service: Perspectives from the firehouse.American Journal of Health Promotion. 2012; 27: 111-118
- Firefighting and mental health: Experiences of repeated exposure to trauma.Work. 2016; 53: 737-744
- Maternal and child health among female firefighters in the US.Maternal and Child Health Journal. 2018; 22: 922-931
- Current cigarette smoking among adults – United States, 2016.MMWR. Morbidity and Mortality Weekly Report. 2018; 67: 53-59
- Smokeless tobacco and dual use among firefighters in the central United States.Journal of Environmental and Public Health. 2013; 2013: 675426
- Tobacco use pattern among a national firefighter cohort.Nicotine & Tobacco Research. 2015; 17: 66-73
- Prevalence and correlates of late initiation of smokeless tobacco in US firefighters.Nicotine & Tobacco Research. 2018; 20: 130-134
- Cigarette smoking transition in females of low socioeconomic status: Impact of state, school, and individual factors.Journal of Epidemiology & Community Health. 2006; 60: 13-19
- Age adjustment using the 2000 projected US population. (Statistical Notes # 20).(Available:)
- Associations of body mass index and obesity with physical activity, food choices, alcohol intake, and smoking in the 1982-1997 FINRISK studies.American Journal of Clinical Nutrition. 2002; 75: 809-817
- The firefighter coping self-efficacy scale: Measure development and validation.Anxiety, Stress, & Coping. 2012; 25: 79-91
- Bureau of Justice statistics crime data brief: Women in law enforcement, 1987-2008.(Available:)
- Cancer risk among firefighters: A review and meta-analysis of 32 studies.Journal of Occupational and Environmental Medicine. 2006; 48: 1189-1202
- Trends in smokeless tobacco use and initiation: 2002 to 2014.(Available:)www.samhsa.gov/data/sites/default/files/report_2740/ShortReport-2740.htmlDate: 2017Date accessed: October 11, 2018
- Total exposure and exposure rate effects for alcohol and smoking and risk of head and neck cancer: A pooled analysis of case-control studies.American Journal of Epidemiology. 2009; 170: 937-947
- Correlates of smoking before, during, and after pregnancy.American Journal of Health Behavior. 2008; 32: 272-282
- 2015 Department of Defense Health Related Behaviors Survey (HRBS).RAND Corporation, Santa Monica, CA2018 (Available:)www.rand.org/pubs/research_reports/RR1695.htmlDate accessed: October 15, 2018
- The Centers for Disease Control and Prevention’s Healthy Days Measures – population tracking of perceived physical and mental health over time.Health and Quality Life Outcomes. 2003; 1: 37
- Firefighter life safety initiatives program: Health, wellness, and fitness.(Available:)www.everyonegoeshome.com/wp-content/uploads/sites/2/2014/08/sandiego06.pdfDate: 2006Date accessed: October 13, 2018
- Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults.National Heart, Lung, and Blood Institute, Bethesda, MD1998
- State-specific prevalence of current cigarette smoking and smokeless tobacco use among adults – United States, 2014.MMWR. Morbidity and Mortality Weekly Report. 2016; 65: 1045-1051
- The CAGE questionnaire for detection of alcoholism: A remarkably useful but simple tool.JAMA. 2008; 300: 2054-2056
- Population representation in the Military services: Fiscal year 2016 summary report.(Available:)
- The subjective effects of alcohol-tobacco co-use: An ecological momentary assessment investigation.Journal of Abnormal Psychology. 2011; 120: 557-571
- The association of smoking and demographic characteristics on body mass index and obesity among adults in the U.S., 1999-2012.BMC Obesity. 2014; 1: 18
- The prevalence of overweight, obesity, and substandard fitness in a population-based firefighter cohort.Journal of Occupational and Environmental Medicine. 2011; 53: 266-273
- A national qualitative study of tobacco use among career firefighters and department health personnel.Nicotine & Tobacco Research. 2012; 14: 734-741
- An examination of the benefits of health promotion programs for the national fire service.BMC Public Health. 2013; 13: 805
- Type of alcoholic beverage and risk of head and neck cancer—a pooled analysis within the INHANCE Consortium.American Journal of Epidemiology. 2009; 169: 132-142
- The influence of subjective social status on vulnerability to postpartum smoking among young pregnant women.American Journal of Public Health. 2007; 97: 1476-1482
- Samet J.M. Yoon S.Y. Gender, women and the tobacco epidemic. World Health Organization, Geneva, Switzerland2010
- Global burden of all-cause and cause-specific mortality due to smokeless tobacco use: Systematic review and meta-analysis.Tobacco Control. 2018; 27: 35-42
- Cardiovascular disease in US firefighters: A systematic review.Cardiology Review. 2011; 19: 202-215
- Women’s sexual orientation and health: Results from a Canadian population-based survey.Women & Health. 2009; 49: 353-367
- Psychological distress/well-being and cognitive functioning measures.in: Stewart A.L. Ware Jr., J.E. Measuring functioning and well being: The medical outcomes study approach. Duke University Press, Durham, NC1992: 102-142
- Key substance use and mental health indicators in the United States: Results from the 2016 National survey on drug use and health.(Available:)www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htmDate: 2017Date accessed: October 13, 2018
- First responders: Behavioral health concerns, emergency response, and trauma.(Available:)www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdfDate: 2018Date accessed: October 9, 2018
- Alcohol consumption and obesity: An update.Current Obesity Reports. 2015; 4: 122-130
- America’s health rankings. A call to action for individuals and their communities.(Available:)http://cdnfiles.americashealthrankings.org/SiteFiles/Reports/Americas-Health-Rankings-2012-v1.pdfDate: 2012Date accessed: October 10, 2018
- National fire department census quick facts.USFA, Emmitsburg, MD2012 (Available:)https://apps.usfa.fema.gov/registry/summaryDate accessed: October 15, 2018
- Prevalence and correlates of lifetime smokeless tobacco use in female military recruits.Nicotine & Tobacco Research. 2005; 7: 431-441
- Binge drinking, drinking and driving, and riding with a driver who had been drinking heavily among Air National Guard and Air Force Reserve Personnel.Military Medicine. 2006; 171: 177-183
- Conceptualization and measurement of health for adults in the Health Insurance Study: Vol. VI.in: Analysis of relationships among health status measures. RAND, Santa Monica, CA1980
- Assessment of validity of self-reported smoking status.Health Reports. 2012; 23: 47-53
Biography
Nattinee Jitnarin, PhD, is Principal Investigator, Institute for Biobehavioral Health Research, National Development and Research Institutes, Inc., and focuses on health behavior, addictive behavior research, and tobacco use, with a background in health outcomes research, statistics, epidemiology, nutrition, and health-related behaviors.
Biography
Walker S.C. Poston, PhD, MPH, is Director, Institute for Biobehavioral Health Research, National Development and Research Institutes, Inc., and Senior Principal Investigator, Center for Fire, Rescue & EMS Health Research. Dr. Poston focuses on epidemiology, obesity, and cardiovascular disease.
Biography
Christopher K. Haddock, PhD, is Deputy Director and Senior Principal Investigator, Institute for Biobehavioral Health Research, National Development and Research Institutes, Inc. Dr. Haddock's research interests are in occupational health, health care policy, and biostatistics.
Biography
Sara A. Jahnke, PhD, is Director, Center for Fire, Rescue & EMS Health Research and Principal Investigator, Institute for Biobehavioral Health Research, National Development & Research Institutes, Inc. Dr. Jahnke works in occupational health, women's health, behavioral health, and qualitative research methods.
Article info
Publication history
Published online: June 19, 2019
Accepted:
May 16,
2019
Received in revised form:
April 30,
2019
Received:
October 22,
2018
Footnotes
Supported by the National Health, Lung and Blood Institute, National Institutes of Health (grant number R21HL119024; S.A. Janhke, PI).
There are no financial conflicts of interest involving any of the authors.
Identification
Copyright
© 2019 Jacobs Institute of Women's Health. Published by Elsevier Inc.
