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Moral injury among women military veterans and demand for cigarettes: A behavioral economic investigation using a hypothetical purchase task

APA Citation:

McDaniel, J. T., Redner, R., Haun, J. N., McCowen, P., & Higgins, S. T. (2024). Moral injury among women military veterans and demand for cigarettes: A behavioral economic investigation using a hypothetical purchase task. Preventive Medicine. Advance online publication. https://doi.org/10.1016/j.ypmed.2024.108036

Focus:

Veterans
Substance use
Trauma
Mental health

Branch of Service:

Multiple branches

Military Affiliation:

Veteran

Subject Affiliation:

Veteran

Population:

Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)

Methodology:

Quantitative Study

Authors:

McDaniel, Justin T., Redner, Ryan, Haun, Jolie N., McCowen, Patrick, Higgins, Stephen T.

Abstract:

OBJECTIVES: Unlike the United States general population, veteran women - as opposed to veteran men - have greater smoking prevalence; yet, little is known regarding factors that influence smoking in veteran women. The purpose of this study was to begin examining the relationship between a psychological concept known as moral injury and demand for cigarettes among veteran women. METHODS: Veteran women who smoke (n = 44) were recruited for this cross-sectional study from Amazon MTurk, Reddit, and a veteran-serving non-profit organization in June-July 2023. Consenting participants received $2 for completing the cigarette purchase task (CPT), Fagerstrom Test for Nicotine Dependence (FTND), and the military version of the Moral Injury Symptom Scale (MISS-M-SF). We examined five CPT demand indices and calculated a modified exponential demand model stratified by moral injury severity status (i.e., probable vs. unlikely). RESULTS: Probable morally injured women exhibited significantly higher relative reinforcing value (RRV) for smoking than unlikely morally injured women (F1, 920 = 9.16, p = 0.003). Average cigarette consumption at $0 (i.e., Q0) was 48.56% higher (M = 22.24 vs. M = 13.55) in probable compared to unlikely morally injured women (p = 0.04, Hedge's g = 0.74). FTND scores were significantly correlated with Pmax (i.e., demand elasticity point) and Omax (i.e., maximum expenditure) values in both populations (rs = 0.42-0.68, ps < 0.05). CONCLUSIONS: We provide preliminary evidence of the relatively high RRV of smoking in morally injured veteran women. Continued research is needed to refine the characterization of this relationship.

Publication Type:

Article

Keywords:

moral injury, smoking, cigarette smoking, women veterans

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