Tobacco and alcohol use among firefighters during their first 3 years of service

Psychol Addict Behav. 2018 May;32(3):255-263. doi: 10.1037/adb0000366.


Firefighters constitute an understudied occupational group that are exposed to a great deal of occupational stress including potentially traumatic stress. As such, higher prevalence rates of posttraumatic stress disorder (PTSD) and substance use disorders have been observed within this population; however, very little is known about the trajectories of health-risk behaviors among firefighters in response to occupational stress over time. The present study enrolled 322 fire service recruits from 7 urban U.S. professional fire departments and followed them through the first 3 years of service. All enrollees were free of Axis I psychopathology at the time of baseline assessments, which were conducted while participants were still enrolled in the fire academy. We hypothesized that: (a) firefighters who used tobacco would have higher levels of alcohol use over time; and (b) firefighters with higher levels of traumatic exposure and mental health symptoms would evidence a stronger multisubstance risk pattern. Analyses provided support for our first hypothesis and revealed that depressive symptoms (but neither trauma exposure nor PTSD symptoms) moderated the alcohol-tobacco relationship. The clinical and public safety implications of these results are discussed. (PsycINFO Database Record

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology*
  • Depression / epidemiology*
  • Female
  • Firefighters*
  • Humans
  • Male
  • Mental Health*
  • Prevalence
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Tobacco Use / epidemiology*
  • Young Adult