Does Alcohol Misuse Differ by Gender and Veteran Status in Adults Ages 25 and Older?

Purpose: There are conflicting findings across previous studies regarding prevalence of alcohol use, binge drinking, and heavy drinking between veteran males and females, and compared to civilians. The purpose of this study was to assess whether alcohol misuse differs by gender and veteran status in adults 25 and older. Methods: Data from the 2015 BRFSS for Maine, Montana, Oregon, South Carolina, and Alaska for veteran and non-veteran males and females ages 25 and older were used in this cross sectional analysis. Multiple logistic regression analysis was used to assess the relationship between alcohol misuse (use, binge, heavy) and veteran status by gender after controlling for age, education level, income level, marital status, race, depression, and smoking status. Results: For adults ages 25 and older, about half (44-59%) reported alcohol use, and about one-tenth reported binge drinking (10-15%) or heavy drinking (5-7%) in the past 30 days. After controlling for demographic and lifestyle factors, alcohol use and binge drinking were directly related (small to moderate effect sizes) to gender and veteran status, with males, both veteran and non-veteran, showing more than female non-veterans in Maine, Montana, Oregon, South Carolina, and Alaska. There was no overall pattern across states for heavy drinking. Conclusion: Overall, alcohol use, binge drinking, and heavy drinking were related to gender and veteran status. Binge drinking and heavy drinking were also related to smoking. For veteran and non-veteran adults ages 25 years and older in a primary care setting, a moderate prevalence of alcohol use may be expected, while a low prevalence of binge drinking, heavy drinking, and smoking may be expected. Although these prevalences may be low, standard of care is to automatically screen for alcohol use and smoking in all patients, both veteran and non-veteran. Therefore, in a primary care setting if signs of binge or heavy drinking are present, providers should consider a more in depth screen for alcohol misuse. Additionally, if signs of either alcohol misuse or smoking are present, providers should consider a more in depth screen for both. Patient education and referrals for alcohol misuse treatment programs and/or smoking cessation counseling should be provided to patients as needed.