Survey Development: A Theory-Driven Mixed Methods Approach provides both an overview of standard methods and tools for developing and validating surveys and a conceptual basis for survey development.
Previous research has shown that 8% to 10% of nonsmokers initiated smoking during their first year of military service despite a period of forced abstinence during boot camp. To our knowledge, no studies have looked at the influence of peers and role models on the initiation of smoking among U.S. Air Force personnel who recently completed boot camp. This cross-sectional study examined the role of perceived peer norms, roommate influence, role model influence, perceived norms of all active duty personnel, and depressive symptoms in the initiation and reinitiation of smoking among 2,962 Air Force technical training students. Previous nonsmokers were more likely to initiate smoking if they perceived that the majority of their classmates smoked (OR 1.67, 95% CI [1.05 to 2.67]) and if they reported that their military training leader or classroom instructor used tobacco products (OR 1.69, 95% CI [1.12 to 2.56]). Additionally, previous nonsmokers were more likely to initiate smoking if their roommate smoked (OR 1.67, 95% CI [1.09 to 2.56]). Similar results were seen with previous smokers who perceived that the majority of their classmates smoked (OR 1.63, 95% CI [1.03 to 2.58]) and if they reported that their military training leader or classroom instructor used tobacco products (OR 1.95, 95% CI [1.29 to 2.94]). Our study suggests that military role models who use tobacco, peer smoking behavior, and perceived smoking norms increase the likelihood of smoking initiation among newly enlisted military personnel who have recently undergone a period of forced abstinence.