â??Stand by Meâ??â??Designated Tobacco Areas on U.S. Military Installations

Stand byMe”—Designated Tobacco Areas on U.S. Military Installations by Robert Thomas Gobble MS, Mississippi State University, 2010 BS, Lindenwood University, 2013 BA, University of Guam, 1995 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University November 2017 Abstract U.S. Air Force (USAF) active duty Airmenshowunusually high tobacco prevalence rates (TPR); i.e., smoke, smokeless, both(SSL-B), when compared to civilian publics in the United States. Tobacco control efforts have proven largely ineffective inlowering nicotine habits among Airmen, while outdoor designated tobacco areas (DTAs) sited near worksites and popular localeson USAF bases (USAFBs) likelyswayAirmen to continue riskynicotine habits. The aim of this inquiry was to assess whetherquantities of DTAs on USAFBs and U.S. airbases (USABs) with 4 mediator variables(quality of DTAs,sites of DTAs, execution of a tobacco cessation program, and types of tobacco cessation programs) wereassociated with TPR (SSL-B) among Airmen at 21 sampled USAF installations worldwide. Organizational cultural theory was the theoretical outline chosen. One USAF surveillance system was accessed,and a survey tool was providedby15 USAF health promotion coordinators and6base civil engineer staff.Correlation assessments and regression analyses were conducted to analyze the survey data. The results of the study revealed that there was a moderate positive correlation among quantities of DTAs and TPR(SSL-B) withAirmen across sampled USAF installations(r= .56, p< .01), and there was a low positive correlation between quantities of DTAs on lower security threat USABs and Airmenpopulace numbers(r= .10, p< .048). Quantities of DTAs were also the strongest predictor of TPR (SSL-B) among Airmen[F(2, 18) = . 00, p< . 013]. Results indicate that fewer or no DTAs on USAFBsand USABs could positively improve theU.S. Air Force (USAF) active duty Airmenshowunusually high tobacco prevalence rates (TPR); i.e., smoke, smokeless, both(SSL-B), when compared to civilian publics in the United States. Tobacco control efforts have proven largely ineffective inlowering nicotine habits among Airmen, while outdoor designated tobacco areas (DTAs) sited near worksites and popular localeson USAF bases (USAFBs) likelyswayAirmen to continue riskynicotine habits. The aim of this inquiry was to assess whetherquantities of DTAs on USAFBs and U.S. airbases (USABs) with 4 mediator variables(quality of DTAs,sites of DTAs, execution of a tobacco cessation program, and types of tobacco cessation programs) wereassociated with TPR (SSL-B) among Airmen at 21 sampled USAF installations worldwide. Organizational cultural theory was the theoretical outline chosen. One USAF surveillance system was accessed,and a survey tool was providedby15 USAF health promotion coordinators and6base civil engineer staff.Correlation assessments and regression analyses were conducted to analyze the survey data. The results of the study revealed that there was a moderate positive correlation among quantities of DTAs and TPR(SSL-B) withAirmen across sampled USAF installations(r= .56, p< .01), and there was a low positive correlation between quantities of DTAs on lower security threat USABs and Airmenpopulace numbers(r= .10, p< .048). Quantities of DTAs were also the strongest predictor of TPR (SSL-B) among Airmen[F(2, 18) = . 00, p< . 013]. Results indicate that fewer or no DTAs on USAFBsand USABs could positively improve the health statuses of active duty USAF Airmen and civilian forces, improve mission duties, lessen health care costs, and foster tobacco-free lifestyles as the normalized behavior on U.S. military installations, and thus promote social change. “Stand by Me”—Designated Tobacco Areas on U.S. Military Installations by Robert Thomas Gobble MS, Mississippi State University, 2010 BS, Lindenwood University, 2013 BA, University of Guam, 1995 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University November 2017 Dedication This dissertation research is dedicated to my parents, who made sacrifices to provide a safe home environment and who enabled me and my siblings to develop honorable characterand deep respect for others. Acknowledgments The continued love, verbal and emotional support, and positive encouragement provided by my lovely wife, Mary, and by my two “impossibly beautiful” children, Amelia and Robert Jr., with this dissertation process will be forever remembered. I also offer a most gracious and heartfelt “thankyou” to Dr. Vasileios Margaritis, who was kind enough to not only serve as my committee chair, but also provide continuous, gentle replies and respectful comments to my draft submissions that surely strengthened each phase of this inquiry. Dr. Margaritis’s enduring patience, verbal encouragement, and direction with every dissertation step made it extremely easy for me to achieve milestones throughout this process. I considered it a most humble honor to have experienced Dr. Margaritis as my committee chair. I would also like to say “thank you” to Dr. Patrick Dunn, who came on board as a committee member later in the process and further provided assistance and guidance with my research questions and with other facets of this study. I also wish to amiably thank each Walden student and faculty member who provided positive comments and guidance with discussions and assignments in each class, particularly statistical courses, that I participated in for this doctoral program. I also wish to express my appreciation to our dearest friends, Benny and Edlira, who helped me to laugh incessantly, when I needed it the most, at life and with school processes. Lastly, this research is dedicated to all the U.S. active duty military members, civilian workforces, DoD contractors, and veterans in all military branches who daily provide endless acts of courage and devotion to duties that ensure the freedom of our nation and of the world.