RISING TRENDS IN CURRENT TOBACCO USE AMONG ACTIVE-DUTY PERSONNEL OF THE ROYAL THAI ARMY IN THAILAND FROM 2017 TO 2022 AND ITS ASSOCIATED METABOLIC RISK FACTORS FOR CARDIOVASCULAR DISEASE IN 2022

Abstract

Background: Tobacco use is a well-established risk factor for developing cardiovascular disease (CVD). In recent years, the prevalence of metabolic risk factors for CVD has been increasing among Royal Thai Army (RTA) personnel in Thailand. Despite a decline in tobacco use, an essential lifestyle risk factor, among Thai civilians from 2015 to 2020, it is unclear how common it is among RTA personnel. Objectives: This study aimed to determine the trends of current tobacco use among active-duty RTA personnel from 2017 to 2022 and to evaluate the association between tobacco use and metabolic risk factors for CVD among this population in 2022. Methods: A serial cross-sectional study was carried out using data from the annual health examination database of RTA personnel from 2017 to 2022. The study included 614,198 active-duty RTA personnel aged 20-60. Current tobacco use was defined as smoking within the previous 12 months. Each year’s adjusted current tobacco use prevalence was estimated using direct standardization to the 2022 study population as a reference. The multivariable logit model was used to evaluate the association between tobacco use and metabolic risk factors for CVD in 2022, presented as an adjusted prevalence ratio (APR) and 95% confidence interval (CI). Results: The age- and sex-adjusted prevalence of current tobacco use among RTA personnel increased from 28.4% (95% CI: 28.1-28.7) in 2017 to 33.2% (95% CI: 33.9-33.4) in 2022, p for trend = 0.021. In men, the age-adjusted prevalence of current tobacco use was 31.8% in 2017 and increased to 36.5% in 2022, p for trend = 0.032. For women, it was 1.1% in 2017 and rose to 5.7% in 2022, p for trend = 0.032. A significant association between current tobacco use and the prevalence of metabolic risk factors for CVD was observed, including diastolic blood pressure ≥ 90 mmHg (APR 1.04; 95% CI 1.01-1.07), fasting plasma glucose ≥ 126 mmHg (APR 1.26; 95% CI 1.18-1.34), and triglyceridemia ≥ 150 mg/dL (APR 1.28; 95% CI 1.25-1.31). Conclusion: The prevalence of current tobacco use among active-duty RTA personnel increased from 2017 to 2022. Additionally, a significant association between tobacco use and metabolic risk factors for CVD was observed. Tobacco cessation should be facilitated in this population to attenuate the risk of CVD later.