Table 3.
Association of Demographic Characteristics, Health Service Use, and Mental Health Diagnoses With Nicotine Dependence Among Subpopulations of Veterans (n = 749,353),a 2008-2009
| Characteristic/Use/Diagnosis | Likelihood of Nicotine Dependence Diagnosis | |||
|---|---|---|---|---|
|
| ||||
| Homeless Veterans, OR (95% CI) (n = 47,252)b | P Valuec | OEF/OIF Veterans, OR (95% CI) (n = 30,297)d | P Valuec | |
| Sex | ||||
| Female | 1 [Reference] | NA | 1 [Reference] | NA |
| Male | 1.2 (1.1-1.2) | <.001 | 1.4 (1.3-1.4) | <.001 |
| Veteran status | ||||
| Other war eras | 1 [Reference] | NA | 1 [Reference] | NA |
| OEF/OIF | 0.8 (0.7-0.8) | <.001 | NA | NC |
| Homeless status | ||||
| Not homeless | NA | NC | 1 [Reference] | NA |
| Homeless | NA | NC | 1.3 (1.2-1.4) | <.001 |
| Agee | 1.0 (1.0-1.0) | .24 | 1.0 (1.0-1.0) | <.001 |
| Race/ethnicity | ||||
| Other | 1 [Reference] | NA | 1 [Reference] | NA |
| White/unknown | 1.2 (0.9-1.7) | .22 | 0.6 (0.1-4.5) | .59 |
| Black | 1.2 (0.8-1.6) | .41 | 0.5 (0.1-4.3) | .57 |
| Hispanic | 0.9 (0.6-1.2) | .36 | 0.3 (0.0-2.3) | .25 |
| Urban/rural residence | ||||
| Urban | 1 [Reference] | NA | 1 [Reference] | NA |
| Large rural | 1.2 (1.1-1.2) | <.001 | 1.4 (1.4-1.5) | <.001 |
| Small rural | 1.2 (1.1-1.3) | <.001 | 1.5 (1.5-1.6) | <.001 |
| Isolated rural | 1.1 (1.0-1.2) | .01 | 1.5 (1.5-1.6) | <.001 |
| Annual income, $ | ||||
| <7,000 | 1 [Reference] | NA | 1 [Reference] | NA |
| 7,000-14,999 | 1.1 (1.1-1.1) | <.001 | 1.1 (1.1-1.2) | <.001 |
| 15,000-24,999 | 1.0 (1.0-1.1) | .66 | 1.1 (1.0-1.1) | <.001 |
| ≥25,000 | 1.0 (0.9 (1.0) | .28 | 1.0 (1.0-1.0) | .99 |
| Disability status | ||||
| Not service-connected | 1 [Reference] | NA | 1 [Reference] | NA |
| Service-connected, <50% disabled | 0.9 (0.9-1.0) | .004 | 1.0 (0.9-1.0) | .004 |
| Service-connected, ≥50% disabled | 1.0 (0.9-1.0) | .12 | 0.9 (0.9-0.9) | <.001 |
| Mental health service use | ||||
| None | 1 [Reference] | NA | 1 [Reference] | NA |
| Any | 1.1 (1.0-1.1) | .01 | 1.3 (1.2-1.3) | <.001 |
| Mental health diagnosis | ||||
| Not having the diagnosis | 1 [Reference] | NA | 1 [Reference] | NA |
| Dementia | 0.7 (0.5-0.8) | <.001 | 0.9 (0.4-1.9) | .77 |
| Schizophrenia | 1.3 (1.2-1.3) | <.001 | 1.2 (1.0-1.4) | .01 |
| Bipolar disorder | 1.1 (1.1-1.2) | <.001 | 1.3 (1.2-1.4) | <.001 |
| Major depression | 1.2 (1.1-1.2) | <.001 | 1.0 (1.0-1.1) | .06 |
| Anxiety disorderf | 1.1 (1.1-1.2) | <.001 | 1.3 (1.2-1.3) | <.001 |
| PTSD | 1.2 (1.1-1.2) | <.001 | 1.3 (1.3-1.4) | <.001 |
| Alcohol use disorder | 2.1 (2.0-2.1) | <.001 | 2.3 (2.2-2.4) | <.001 |
| Drug use disorder | 1.9 (1.9-2.0) | <.001 | 2.0 (1.9-2.1) | <.001 |
| Personality disorder | 1.1 (1.0-1.1) | .02 | 1.1 (1.0-1.3) | .01 |
Abbreviations: OR, odds ratio; CI, confidence interval; OEF/OIF, Operation Enduring Freedom/Operation Iraqi Freedom; NA, not applicable; NC, not calculated; PTSD, post-traumatic stress disorder.
Among veterans for whom nicotine dependence diagnosis was documented in administrative records of the US Department of Veterans Affairs (VA) health system.
Represents 39.3% of all homeless VA health system users (n = 120,234).
Calculated by using the χ2 test.
Represents 15.1% of all OEF/OIF VA health system users (n = 200,300).
OR for age represents odds with every increase of 10 years.
Excludes PTSD.