Combat exposure, emotional and physical role limitations, and substance use among male United States Army Reserve and National Guard soldiers

Combat-exposed soldiers are at an increased risk for health problems that diminish quality of life (QOL) and substance use. We explored the cross-sectional associations between combat exposure and two measures of QOL, and the effect of substance use on those associations.

Greater combat exposure was independently associated with limitations in usual activity due to physical (regression coefficient = −0.35, 95% CI −0.55 to −0.16, R ² = 0.09; p < 0.01) and emotional (regression coefficient = −0.32, 95% CI −0.56 to −0.09, R ² = 0.09; p < 0.01) problems. Combat exposure had a significant interaction with frequent heavy drinking on physical role limitations (regression coefficient = −0.65, 95% CI −1.18 to −0.12, R ² = 0.12; p < 0.05) and emotional role limitations (regression coefficient = −0.83, 95% CI −1.46 to −0.19, R ² = 0.12; p < 0.05). Combat exposure also had a significant interaction with lifetime non-medical use of prescription drugs on physical role limitations (regression coefficient = 0.81, 95% CI 0.18–1.45, R ² = 0.11; p < 0.05).

Combat is an unmodifiable risk factor for poor QOL among soldiers; however, frequent heavy drinking and non-medical use of prescription drugs modifies the relationship between combat exposure and QOL. Therefore, substance use is a potential point of intervention to improve QOL among soldiers.