Page 35 - Biobehavioral Resilence to Stress

12 Biobehavioral Resilience to Stress

Smoking Behavior
In the literature review sponsored by the Center for Accessions Research,
Knapik et al. (2004) cited six studies that revealed a statistically signifi cant
relationship between smoking behavior and attrition from the military
(Booth-Kewley, Larson & Ryan, 2002; Knox, 1998; Larson, Booth-Kewley &
Ryan, 2002; Quester, 1999; Snoddy & Henderson, 1994; Talcott, Haddock,
Klesges, Lando & Fiedler, 1999). Other studies have reported similar results
(e.g., Flyer, 2004; Hattiangadi, Lee & Quester, 2004; Klesges, Haddock, Chang,
Talcott & Lando, 2001). For example, Klesges et al. (2001) observed that
smokers in the U.S. Air Force were 1.8 times more likely than nonsmokers
to be discharged during their first year of military enlistment. Remarkably, a

history of smoking behavior is predictive of attrition even aft er smokers have
stopped smoking.
In a study of U.S. Navy trainees who were tested during basic training,
Flyer (2004) found that the rate of attrition for smokers was nearly twice (75%)
that of nonsmokers (37.3%) among trainees who had a GED or were non–high
school graduates. In fact, the rate of attrition among nongraduate nonsmokers
was more closely comparable to that of all trainees who held a traditional high
school diploma (31%).
It would be reasonable to think that higher rates of attrition among
smokers might be related to the physical effects of smoking, but studies to

date suggest otherwise. The aerobic capacity of smokers in basic training
is similar to that of nonsmokers (Daniels et al., 1984; Knapik et al., 2001).
Although individuals who are smokers may have more medical problems in
basic training, two studies (Booth-Kewley et al., 2002; Talcott et al., 1999)
report that the association between cigarette smoking and medical attrition
is very weak and that cigarette smoking is primarily a risk factor for legal
and behavioral discharges (e.g., discharges related to fraudulent entry, mis-

conduct, the commission of a serious offense, substandard performance,
personality disorder, drug/alcohol abuse). The working group sponsored by

the Center for Accessions Research (Knapik et al., 2004, p. 25) concluded that
“cigarette smoking may be a marker for some yet undefi ned psychosocial fac-
tors (e.g., risk taking) that is linked with attrition.”
Recent findings also suggest that smoking may be linked not only to

attrition, but also to other types of negative outcomes. For example, in a
Finnish study of 10,943 adolescents, regular smoking at age 14 predicted
later drunk driving (Riala, Hakko, Isohanni, Järvelin & Räsänen, 2004). In
the U.S. military, a study of 6950 Navy recruits tested during basic training
linked smoking to a history of antisocial behavior and subsequent diffi cul-
ties during training (Flyer & Eitelberg, 2005). Heavy smokers (those who
smoked a pack or more a day) were three times more likely than nonsmokers to
have a record of truancy and multiple suspensions from high school. Almost
one in five (19%) smokers reported having been in trouble with the police

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