Self-Reported Smoking and Musculoskeletal Overuse Injury Among Male and Female US Marine Corps Recruits

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The association between self-reported smoking and overuse injury in a cohort of young men (n=900) and women (n=597) undergoing 12 weeks of standardized military instruction, after adjustment for physical activity, health history, and incoming fitness tests was examined. The outcome includes all International Classification of Diseases, 9th Revision codes related to injuries resulting from cumulative microtrauma (overuse injuries). The short survey asked about the subject’s demographics, smoking habits, prior injuries sustained, physical activity level, selfperceived fitness, and (for women) menstrual history. From the survey, 4 questions established smoking behavior: smoked at least 100 cigarettes in lifetime, age smoked a whole cigarette for the first time, how many cigarettes smoked during the last 30 days, and how many cigarettes smoked per day during the last 30 days. None of the adjusted hazard ratios for the smoking questions were associated with an increased risk of overuse injury for either sex. Furthermore, this study did not find a significant association with respect to smoking and all injuries in either men or women. In conclusion, smoking does not appear to be an independent risk factor for overuse injury in either young men or women during 12 weeks of standardized military instruction.


This article was originally published in Military Medicine, volume 179, issue 7, in 2014. DOI: 10.7205/MILMED-D-13-00516

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Association of Military Surgeons of the U.S