Abstract
ABSTRACTAlcohol and substance use can challenge military veterans who live in rural communities. In 2016, the screening, brief intervention, and referral to treatment in Alabama (AL-SBIRT) program was implemented in west Alabama. The primary aim of this study was to determine whether current tobacco use modified the relationship between veteran status and substance misuse. Self-reported wellness data was collected regarding substance, alcohol, or tobacco consumption. Risk levels for alcohol and drug use were measured using the United States Alcohol Use Disorders Identification Test (US-AUDIT) and the Drug Abuse Screening Test (DAST)-10. Substance and tobacco use were significantly and positively correlated. Veterans had a higher US-AUDIT and DAST score than nonveterans, and tobacco appeared to be an exacerbating factor. Effective evidence-based interventions are needed in rural settings. Technology based programs and motivational interviewing with trained clinicians may serve as beneficial and cost-effective interventions for tobacco use prevention and cessation efforts.
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