To examine whether military separation (Veteran), service component (active duty, Reserve/National Guard), and combat deployment are prospectively associated with continuing unhealthy alcohol
use among US military service members.
Millennium Cohort Study participants were evaluated for continued or chronic unhealthy alcohol
use, defined by screening positive at baseline and the next consecutive follow-up survey for heavy episodic, heavy weekly, or problem drinking
. Participants meeting criteria for chronic unhealthy alcohol
use were followed for up to 12 years to determine continued unhealthy use. Multivariable regression models—adjusted for demographics, military service factors, and behavioral and mental health characteristics—assessed whether separation status, service component, or combat deployment were associated with continuation of 3 unhealthy drinking
outcomes: heavy weekly (sample n = 2653), heavy episodic (sample n = 22,933), and problem drinking
(sample n = 2671).
In adjusted models, Veterans (compared with actively serving personnel) and Reserve/Guard (compared with active duty members) had a significantly higher likelihood of continued chronic use for heavy weekly, heavy episodic, and problem drinking
(Veteran odds ratio [OR] range 1.17–1.47; Reserve/Guard OR range 1.25–1.29). Deployers without combat experience were less likely than nondeployers to continue heavy weekly drinking
(OR 0.75, 95% confidence interval 0.61–0.91).
The elevated likelihood of continued unhealthy alcohol
use among Veterans and Reserve/Guard members suggests that strategies to reduce unhealthy drinking
targeted to these populations may be warranted.