TABLE 3.
Risk for Smoking Initiation by 17 PCL-C Symptoms (2001–2012)
| PCL-C Item | Iterative Models | All Participants N=44,968 RR (95% CI) |
Subsample With PTSD N=1622 RR (95% CI) |
|---|---|---|---|
| Re-experiencing | |||
| Repeated, disturbing memories of stressful experiences from the past | Model 1: Unadjusted | 1.50 (1.29, 1.73) | 1.64 (1.20, 2.23) |
| Model 2: Adjusted for demographic characteristics | 1.14 (1.06, 1.21) | 1.20 (1.02, 1.42) | |
| Model 3: Model 2 + service-related characteristics | 1.11 (1.04, 1.19) | 1.21 (1.02, 1.43) | |
| Model 4: Model 3 + health-related characteristics | 1.04 (0.97, 1.12) | 1.17 (0.98, 1.39) | |
| Model 5: Model 4 + other PCL symptoms | 1.02 (0.92, 1.14) | 1.16 (0.96, 1.41) | |
| Repeated, disturbing dreams of stressful experiences from the past | Model 1: Unadjusted | 1.58 (1.33, 1.87) | 1.47 (1.11, 1.95) |
| Model 2: Adjusted for demographic characteristics | 1.17 (1.08, 1.26) | 1.17 (0.99, 1.36) | |
| Model 3: Model 2 + service-related characteristics | 1.14 (1.05, 1.23) | 1.17 (0.99, 1.36) | |
| Model 4: Model 3 + health-related characteristics | 1.06 (0.97, 1.15) | 1.14 (0.97, 1.34) | |
| Model 5: Model 4 + other PCL symptoms | 0.99 (0.88, 1.13) | 1.04 (0.87, 1.25) | |
| Suddenly acting or feeling as if stressful experiences were happening again | Model 1: Unadjusted | 1.61 (1.36, 1.90) | 1.45 (1.09, 1.94) |
| Model 2: Adjusted for demographic characteristics | 1.15 (1.06, 1.23) | 1.12 (0.96, 1.31) | |
| Model 3: Model 2 + service-related characteristics | 1.12 (1.04, 1.21) | 1.11 (0.95, 1.30) | |
| Model 4: Model 3 + health-related characteristics | 1.03 (0.95, 1.12) | 1.08 (0.91, 1.27) | |
| Model 5: Model 4 + other PCL symptoms | 1.01 (0.89, 1.14) | 1.04 (0.87, 1.24) | |
| Feeling very upset when something happened that reminds you of stressful experiences from the past | Model 1: Unadjusted | 1.48 (1.27, 1.71) | 1.29 (0.95, 1.76) |
| Model 2: Adjusted for demographic characteristics | 1.10 (1.03, 1.18) | 1.05 (0.88, 1.24) | |
| Model 3: Model 2 + service-related characteristics | 1.08 (1.01, 1.16) | 1.05 (0.88, 1.24) | |
| Model 4: Model 3 + health-related characteristics | 1.00 (0.93, 1.08) | 0.99 (0.83, 1.18) | |
| Model 5: Model 4 + other PCL symptoms | 0.95 (0.84, 1.06) | 0.88 (0.72, 1.07) | |
| Physical reactions when something reminds you of stressful experiences from the past | Model 1: Unadjusted | 1.69 (1.40, 2.03) | 1.39 (1.05, 1.84) |
| Model 2: Adjusted for demographic characteristics | 1.16 (1.07, 1.26) | 1.15 (0.99, 1.34) | |
| Model 3: Model 2 + service-related characteristics | 1.14 (1.05, 1.24) | 1.15 (0.98, 1.34) | |
| Model 4: Model 3 + health-related characteristics | 1.04 (0.95, 1.14) | 1.09 (0.93, 1.29) | |
| Model 5: Model 4 + other PCL symptoms | 1.05 (0.92, 1.20) | 1.07 (0.90, 1.28) | |
| Emotional numbing | |||
| Trouble remembering important parts of stressful experiences from the past | Model 1: Unadjusted | 1.63 (1.35, 1.98) | 1.31 (0.99, 1.74) |
| Model 2: Adjusted for demographic characteristics | 1.15 (1.06, 1.25) | 1.08 (0.93, 1.26) | |
| Model 3: Model 2 + service-related characteristics | 1.12 (1.03, 1.22) | 1.07 (0.92, 1.25) | |
| Model 4: Model 3 + health-related characteristics | 1.03 (0.94, 1.13) | 1.03 (0.88, 1.21) | |
| Model 5: Model 4 + other PCL symptoms | 1.03 (0.91, 1.15) | 1.06 (0.90, 1.25) | |
| Loss of interest in activities that you used to enjoy | Model 1: Unadjusted | 1.50 (1.31, 1.71) | 1.38 (1.00, 1.90) |
| Model 2: Adjusted for demographic characteristics | 1.12 (1.05, 1.19) | 1.15 (0.97, 1.37) | |
| Model 3: Model 2 + service-related characteristics | 1.10 (1.03, 1.16) | 1.15 (0.97, 1.37) | |
| Model 4: Model 3 + health-related characteristics | 1.04 (0.97, 1.12) | 1.15 (0.95, 1.38) | |
| Model 5: Model 4 + other PCL symptoms | 1.02 (0.93, 1.12) | 1.10 (0.91, 1.33) | |
| Feeling distant or cut off from other people | Model 1: Unadjusted | 1.47 (1.30, 1.66) | 1.26 (0.89, 1.77) |
| Model 2: Adjusted for demographic characteristics | 1.10 (1.04, 1.16) | 1.06 (0.87, 1.28) | |
| Model 3: Model 2 + service-related characteristics | 1.08 (1.02, 1.14) | 1.05 (0.87, 1.28) | |
| Model 4: Model 3 + health-related characteristics | 1.02 (0.96, 1.08) | 1.02 (0.84, 1.25) | |
| Model 5: Model 4 + other PCL symptoms | 0.97 (0.89, 1.07) | 0.90 (0.73, 1.10) | |
| Feeling emotionally numb, or being unable to have loving feelings for those close to you | Model 1: Unadjusted | 1.51 (1.32, 1.74) | 1.26 (0.93, 1.70) |
| Model 2: Adjusted for demographic characteristics | 1.09 (1.02, 1.16) | 1.05 (0.89, 1.23) | |
| Model 3: Model 2 + service-related characteristics | 1.07 (1.01, 1.14) | 1.06 (0.90, 1.25) | |
| Model 4: Model 3 + health-related characteristics | 1.00 (0.93, 1.07) | 1.02 (0.86, 1.21) | |
| Model 5: Model 4 + other PCL symptoms | 0.99 (0.90, 1.08) | 0.97 (0.82, 1.15) | |
| Feeling as if your future will somehow be cut short | Model 1: Unadjusted | 1.64 (1.40, 1.92) | 1.57 (1.18, 2.09) |
| Model 2: Adjusted for demographic characteristics | 1.17 (1.09, 1.26) | 1.27 (1.09, 1.49) | |
| Model 3: Model 2 + service-related characteristics | 1.15 (1.07, 1.23) | 1.28 (1.10, 1.50) | |
| Model 4: Model 3 + health-related characteristics | 1.08 (1.01, 1.17) | 1.27 (1.08, 1.49) | |
| Model 5: Model 4 + other PCL symptoms | 1.08 (0.98, 1.20) | 1.19 (1.02, 1.40) | |
| Anxious arousal | |||
| Feeling “super alert” or watchful or on guard | Model 1: Unadjusted | 1.54 (1.33, 1.77) | 1.23 (0.93, 1.63) |
| Model 2: Adjusted for demographic characteristics | 1.09 (1.02, 1.16) | 1.04 (0.90, 1.22) | |
| Model 3: Model 2 + service-related characteristics | 1.06 (0.99, 1.14) | 1.04 (0.90, 1.22) | |
| Model 4: Model 3 + health-related characteristics | 1.00 (0.93, 1.07) | 0.99 (0.84, 1.16) | |
| Model 5: Model 4 + other PCL symptoms | 0.99 (0.90, 1.09) | 0.97 (0.82, 1.15) | |
| Feeling jumpy or easily startled | Model 1: Unadjusted | 1.57 (1.33, 1.85) | 1.22 (0.92, 1.61) |
| Model 2: Adjusted for demographic characteristics | 1.11 (1.03, 1.19) | 1.03 (0.89, 1.20) | |
| Model 3: Model 2 + service-related characteristics | 1.08 (1.01, 1.17) | 1.03 (0.88, 1.20) | |
| Model 4: Model 3 + health-related characteristics | 1.00 (0.92, 1.08) | 0.96 (0.81, 1.13) | |
| Model 5: Model 4 + other PCL symptoms | 0.97 (0.87, 1.08) | 0.93 (0.77, 1.11) | |
| Dysphoric arousal | |||
| Trouble falling asleep or staying asleep | Model 1: Unadjusted | 1.42 (1.28, 1.57) | 1.46 (1.03, 2.07) |
| Model 2: Adjusted for demographic characteristics | 1.09 (1.04, 1.14) | 1.25 (1.03, 1.52) | |
| Model 3: Model 2 + service-related characteristics | 1.07 (1.02, 1.12) | 1.25 (1.03, 1.52) | |
| Model 4: Model 3 + health-related characteristics | 1.01 (0.96, 1.06) | 1.22 (0.99, 1.49) | |
| Model 5: Model 4 + other PCL symptoms | 1.03 (0.96, 1.09) | 1.03 (0.84, 1.24) | |
| Feeling irritable or having angry outbursts | Model 1: Unadjusted | 1.59 (1.42, 1.79) | 2.32 (1.56, 3.44) |
| Model 2: Adjusted for demographic characteristics | 1.14 (1.08, 1.20) | 1.35 (1.10, 1.67) | |
| Model 3: Model 2 + service-related characteristics | 1.12 (1.06, 1.18) | 1.37 (1.11, 1.69) | |
| Model 4: Model 3 + health-related characteristics | 1.06 (0.99, 1.12) | 1.36 (1.10, 1.69) | |
| Model 5: Model 4 + other PCL symptoms | 1.06 (0.99, 1.15) | 1.41 (1.13, 1.76) | |
| Difficulty concentrating | Model 1: Unadjusted | 1.47 (1.28, 1.67) | 1.02 (0.76, 1.38) |
| Model 2: Adjusted for demographic characteristics | 1.11 (1.04, 1.17) | 1.00 (0.85, 1.18) | |
| Model 3: Model 2 + service-related characteristics | 1.09 (1.02, 1.15) | 1.01 (0.86, 1.19) | |
| Model 4: Model 3 + health-related characteristics | 1.02 (0.95, 1.09) | 0.97 (0.81, 1.15) | |
| Model 5: Model 4 + other PCL symptoms | 0.98 (0.90, 1.07) | 0.85 (0.71, 1.01) | |
| Avoidance | |||
| Efforts to avoid thinking about your stressful experiences from the past or avoid having feelings about them | Model 1: Unadjusted | 1.45 (1.23, 1.70) | 1.31 (0.98, 1.74) |
| Model 2: Adjusted for demographic characteristics | 1.09 (1.02, 1.17) | 1.02 (0.87, 1.20) | |
| Model 3: Model 2 + service-related characteristics | 1.07 (0.99, 1.15) | 1.02 (0.87, 1.19) | |
| Model 4: Model 3 + health-related characteristics | 0.98 (0.91, 1.06) | 0.97 (0.82, 1.14) | |
| Model 5: Model 4 + other PCL symptoms | 0.94 (0.83, 1.06) | 0.94 (0.78, 1.14) | |
| Efforts to avoid activities or situations because they remind you of stressful experiences from the past | Model 1: Unadjusted | 1.51 (1.26, 1.80) | 1.26 (0.95, 1.67) |
| Model 2: Adjusted for demographic characteristics | 1.12 (1.04, 1.21) | 1.07 (0.91, 1.24) | |
| Model 3: Model 2 + service-related characteristics | 1.10 (1.02, 1.19) | 1.07 (0.91, 1.24) | |
| Model 4: Model 3 + health-related characteristics | 1.01 (0.92, 1.10) | 1.02 (0.87, 1.20) | |
| Model 5: Model 4 + other PCL symptoms | 1.00 (0.87, 1.14) | 0.99 (0.82, 1.19) | |
Demographic characteristics: age, sex, race/ethnicity, education, marital status, military pay grade.
Service-related characteristics: service branch, service component, occupation, combat deployment, deployment prior to baseline, separation from military service.
Health characteristics: physical component summary score, life stressors, panic/anxiety, depression, body mass index, alcohol misuse.
PCL-C, PTSD Checklist – Civilian Version; PTSD, posttraumatic stress disorder; CI, confidence interval; RR, risk ratio.