Abstract
In high-risk, 24/7 occupations, stimulants can serve as a countermeasure to acute stressors. However, chronic stimulant use may negatively impact operational readiness and health. Using cross-sectional data from 15,880 U.S. Navy personnel, we assessed relationships between job stress, sleep quantity and disturbance, and daily caffeine and nicotine use on readiness and health in the operational environment. Under operationally-relevant conditions of mid-high stress and poor sleep, use of caffeinated beverages (coffee/soda/tea), energy drinks, caffeine supplements (gum/pill), combustible tobacco (cigarette/cigar/pipe), electronic nicotine delivery systems (ENDS; e-cigarettes/vape), and smokeless nicotine (chew/snuff/patch/gum) associated with either no effects or significant decrements in functional performance capacity. Caffeinated beverages benefit physical and mental health under moderate job stress and low sleep quantity (< 5 h/day), but decrement under high stress; energy drinks and supplements were neutral or detrimental to health. Combustible tobacco benefits physical health under high sleep disturbance, but decrements mental health under low sleep quantity. ENDS use was neutral to physical health, with benefits in mental health under high sleep disturbance but decrements under low sleep quantity. Smokeless nicotine was neutral to health. Overall, under high operational stress conditions, caffeine associated with significant benefits to readiness and health in 4% of conditions vs. decrements in 68% of conditions; nicotine associated with benefits in 7% vs. decrements in 11% of conditions. These data indicate that in high-risk work environments, chronic stimulant use has limited benefits as a sustained countermeasure, and may be more counterproductive by compounding the detrimental effects of occupational stressors on operational readiness and health.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The data underlying this article cannot be shared publicly because they are the property of the U.S. Department of Defense.
Notes
U.S. servicemembers can purchase nicotine products at military stores and consume them in designated areas at military facilities. Although tobacco product use is prohibited inside of Navy vessels, commanding officers may designate outside-facing exterior “weather decks” as tobacco use areas (Department of the Navy, 2021). The presence of smoked nicotine use in otherwise unauthorized locations (e.g., “stealth vaping”; Williams et al., 2022) is recognized but its prevalence is unknown.
References
Altarac, M., Gardner, J. W., Popovich, R. M., Potter, R., Knapik, J. J., & Jones, B. H. (2000). Cigarette smoking and exercise-related injuries among young men and women. American Journal of Preventive Medicine, 18(3), 96–102. https://doi.org/10.1016/S0749-3797(99)00166-X
Andreotti, G., Freedman, N. D., Silverman, D. T., Lerro, C. C., Koutros, S., Hartge, P., Alavanja, M. C., Sandler, D. P., & Freeman, L. B. (2017). Tobacco use and cancer risk in the Agricultural Health Study. Cancer Epidemiology, Biomarkers & Prevention, 26(5), 769–778. https://doi.org/10.1158/1055-9965.EPI-16-0748
Asare, B.Y.-A., Kwasnicka, D., Powell, D., & Robinson, S. (2021). Health and well-being of rotation workers in the mining, offshore oil and gas, and construction industry: A systematic review. BMJ Global Health, 6(7), e005112. https://doi.org/10.1136/bmjgh-2021-005112
Austin, K. G., Price, L. L., McGraw, S. M., McLellan, T. M., & Lieberman, H. R. (2016). Longitudinal trends in use of dietary supplements by U.S. Army personnel differ from those of civilians. Applied Physiology Nutrition and Metabolism, 41(12), 1217–1224. https://doi.org/10.1139/apnm-2016-0296.
Becker, T. D., Arnold, M. K., Ro, V., Martin, L., & Rice, T. R. (2021). Systematic review of electronic cigarette use (vaping) and mental health comorbidity among adolescents and young adults. Nicotine & Tobacco Research, 23(3), 415–425. https://doi.org/10.1093/ntr/ntaa171
Caldwell, J. A., & Caldwell, J. L. (2005). Fatigue in military aviation: An overview of US military-approved pharmacological countermeasures. Aviation, Space, and Environmental Medicine, 76(7 Suppl), C39-51.
Cappelletti, S., Piacentino, D., Sani, G., & Aromatario, M. (2015). Caffeine: Cognitive and physical performance enhancer or psychoactive drug? Current Neuropharmacology, 13(1), 71–88. https://doi.org/10.2174/1570159X13666141210215655
Carleton, R. N., Afifi, T. O., Taillieu, T., Turner, S., Mason, J. E., Ricciardelli, R., McCreary, D. R., Vaughan, A. D., Anderson, G. S., Krakauer, R. L., Donnelly, E. A., Camp, R. D., 2nd., Groll, D., Cramm, H. A., MacPhee, R. S., & Griffiths, C. T. (2020). Assessing the relative impact of diverse stressors among public Safety Personnel. International Journal of Environmental Research and Public Health, 17(4), 1234. https://doi.org/10.3390/ijerph17041234
Catoire, S., Nourredine, M., Lefebvre, S., Couraud, S., Gronfier, C., Rey, R., Peter-Derex, L., Geoffroy, P. A., & Rolland, B. (2021). Tobacco-induced sleep disturbances: A systematic review and meta-analysis. Sleep Medicine Reviews, 60(101544), 101544. https://doi.org/10.1016/j.smrv.2021.101544
Centers for Disease Control and Prevention. (2000). Measuring healthy days: Population assessment of health-related quality of life. Atlanta (GA): CDC. https://stacks.cdc.gov/view/cdc/6406.
Chaput, J.-P., Dutil, C., Featherstone, R., Ross, R., Giangregorio, L., Saunders, T. J., Janssen, I., Poitras, V. J., Kho, M. E., Ross-White, A., & Carrier, J. (2020). Sleep duration and health in adults: An overview of systematic reviews. Applied Physiology Nutrition and Metabolism, 45(10 (Suppl. 2)), S218–S231. https://doi.org/10.1139/apnm-2020-0034.
Chaudhary, N. S., Taylor, B. V., Grandner, M. A., Troxel, W. M., & Chakravorty, S. (2021). The effects of caffeinated products on sleep and functioning in the military population: A focused review. Pharmacology, Biochemistry, and Behavior, 206(173206), 173206. https://doi.org/10.1016/j.pbb.2021.173206
Chen, M.-J., & Cunradi, C. (2008). Job stress, burnout and substance use among urban transit operators: The potential mediating role of coping behaviour. Work and Stress, 22(4), 327–340. https://doi.org/10.1080/02678370802573992
Chen, W.-Q., Wong, T. W., & Yu, I.T.-S. (2008). Association of occupational stress and social support with health-related behaviors among offshore oil workers. Journal of Occupational Health, 50(3), 262–269. https://doi.org/10.1539/joh.l7149
Cho, M. S. (2020). Use of alcohol, tobacco, and caffeine and suicide attempts: Findings from a nationally representative cross-sectional study. Journal of Primary Care & Community Health, 11, 1–7. https://doi.org/10.1177/2150132720913720
Colligan, T. W., & Higgins, E. M. (2006). Workplace stress: Etiology and consequences. Journal of Workplace Behavioral Health, 21(2), 89–97. https://doi.org/10.1300/j490v21n02_07
Costa, G. (2020). Shift work and occupational hazards. In: T. Theorell (Ed.) Handbook of Socioeconomic Determinants of Occupational Health (pp. 1–18). Cham: Springer. https://doi.org/10.1007/978-3-030-05031-3_3-1.
Coxe, S., West, S. G., & Aiken, L. S. (2009). The analysis of count data: A gentle introduction to Poisson regression and its alternatives. Journal of Personality Assessment, 91(2), 121–136. https://doi.org/10.1080/00223890802634175
Crank, J. P., Regoli, R., Hewitt, J. D., & Culbertson, R. G. (1995). Institutional and organizational antecedents of role stress, work alienation, and anomie among police executives. Criminal Justice and Behavior, 22(2), 152–171. https://doi.org/10.1177/0093854895022002004
Crawford, C., Teo, L., Lafferty, L., Drake, A., Bingham, J. J., Gallon, M. D., O’Connell, M. L., Chittum, H. K., Arzola, S. M., & Berry, K. (2017). Caffeine to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field. Nutrition Reviews, 75(suppl_2), 17–35. https://doi.org/10.1093/nutrit/nux007.
Crum-Cianflone, N. F., Powell, T. M., LeardMann, C. A., Russell, D. W., & Boyko, E. J. (2016). Mental health and comorbidities in US military members. Military Medicine, 181(6), 537–545. https://doi.org/10.7205/MILMED-D-15-00187
Davenport, M. K., Ruffin, M. A., Oxendahl, T. A., McSpedon, M. R., & Beier, M. E. (2022). “Small” effects, big problems. Work, Aging, and Retirement, 8(4), 368–370. https://doi.org/10.1093/workar/waac012
de Mejia, E. G., & Ramirez-Mares, M. V. (2014). Impact of caffeine and coffee on our health. Trends in Endocrinology and Metabolism, 25(10), 489–492. https://doi.org/10.1016/j.tem.2014.07.003
Department of the Navy. (2021). SECNAV INSTRUCTION 5100.13F. Washington, DC: Department of the Navy. https://www.secnav.navy.mil/doni/Directives/05000%20General%20Management%20Security%20and%20Safety%20Services/05-100%20Safety%20and%20Occupational%20Health%20Services/5100.13F.pdf
Donaldson, C. D., Stupplebeen, D. A., Fecho, C. L., Ta, T., Zhang, X., & Williams, R. J. (2022). Nicotine vaping for relaxation and coping: Race/ethnicity differences and social connectedness mechanisms. Addictive Behaviors, 132(107365), 107365. https://doi.org/10.1016/j.addbeh.2022.107365
Doty, T. J., So, C. J., Bergman, E. M., Trach, S. K., Ratcliffe, R. H., Yarnell, A. M., Capaldi, V. F., Moon, J. E., Balkin, T. J., & Quartana, P. J. (2017). Limited efficacy of caffeine and recovery costs during and following 5 days of chronic sleep restriction. Sleep, 40(12), zsx171. https://doi.org/10.1093/sleep/zsx171.
Fahey, M. C., Krukowski, R. A., Talcott, G. W., & Little, M. A. (2020). JUUL targets military personnel and veterans. Tobacco Control, 29(e1), e163–e164. https://doi.org/10.1136/tobaccocontrol-2019-055377
Fairman, R. T., Weaver, S. R., Akani, B. C., Dixon, K., & Popova, L. (2021). “You have to vape to make it through”: E-cigarette outcome expectancies among youth and parents. American Journal of Health Behavior, 45(5), 933–946. https://doi.org/10.5993/AJHB.45.5.13
Fishbein, A. B., Knutson, K. L., & Zee, P. C. (2021). Circadian disruption and human health. The Journal of Clinical Investigation, 131(19), e148286. https://doi.org/10.1172/JCI148286
Gallucci M. (2019). GAMLj: General Analyses for Linear Models [jamovi module]. Retrieved from https://gamlj.github.io/.
Ganster, D. C., & Rosen, C. C. (2013). Work stress and employee health: A multidisciplinary review. Journal of Management, 39(5), 1085–1122. https://doi.org/10.1177/0149206313475815
Garcia, A. N., & Salloum, I. M. (2015). Polysomnographic sleep disturbances in nicotine, caffeine, alcohol, cocaine, opioid, and cannabis use: A focused review: Polysomnographic Changes in Substance Use. The American Journal on Addictions, 24(7), 590–598. https://doi.org/10.1111/ajad.12291
Glasser, A. M., Collins, L., Pearson, J. L., Abudayyeh, H., Niaura, R. S., Abrams, D. B., & Villanti, A. C. (2016). Overview of electronic nicotine delivery systems: A systematic review. American Journal of Preventive Medicine, 52(2), e33–e66. https://doi.org/10.1016/j.amepre.2016.10.036
Gnambs, T., & Kaspar, K. (2015). Disclosure of sensitive behaviors across self-administered survey modes: A meta-analysis. Behavior Research Methods, 47(4), 1237–1259. https://doi.org/10.3758/s13428-014-0533-4
Götz, F. M., Gosling, S. D., & Rentfrow, P. J. (2022). Small effects: The indispensable foundation for a cumulative psychological science. Perspectives on Psychological Science, 17(1), 205–215. https://doi.org/10.1177/1745691620984483
Gunia, B. C., Adler, A. B., Bliese, P. D., & Sutcliffe, K. M. (2021). How are you Sleeping? Leadership Support, Sleep Health, and Work-Relevant Outcomes. Occupational Health Science, 5(4), 563–580. https://doi.org/10.1007/s41542-021-00100-w
Harrison, E., Glickman, G. L., Beckerley, S., & Taylor, M. K. (2017). Self-reported sleep during US Navy operations and the impact of deployment-related factors. Military Medicine, 182(suppl_1), 189–194. https://doi.org/10.7205/MILMED-D-16-00078.
Herberman Mash, H. B., Fullerton, C. S., Ramsawh, H. J., Ng, T. H. H., Wang, L., Kessler, R. C., Stein, M. B., & Ursano, R. J. (2014). Risk for suicidal behaviors associated with alcohol and energy drink use in the US Army. Social Psychiatry and Psychiatric Epidemiology, 49(9), 1379–87. https://doi.org/10.1007/s00127-014-0886-0
Jagim, A. R., Harty, P. S., Fischer, K. M., Kerksick, C. M., & Erickson, J. L. (2020). Adverse events reported to the United States Food and Drug Administration related to caffeine-containing products. Mayo Clinic Proceedings, 95(8), 1594–1603). https://doi.org/10.1016/j.mayocp.2020.02.033.
James, S. M., Honn, K. A., Gaddameedhi, S., & Van Dongen, H. P. (2017). Shift work: Disrupted circadian rhythms and sleep—implications for health and well-being. Current Sleep Medicine Reports, 3, 104–112. https://doi.org/10.1007/s40675-017-0071-6
Jameson, J. T., Markwald, R. R., Kubala, A. G., Roma, P. G., Biggs, A. T., Lai, K., & Russell, D. W. (2023). Sleep deficiency, operational fatigue and the interplay of compromising factors: Analysis to aid in fatigue management. Journal of Sleep Research, 32(3), e13788. https://doi.org/10.1111/jsr.13788
Kasper, A. M., & Close, G. L. (2021). Practitioner observations of oral nicotine use in elite sport: You snus you lose. European Journal of Sport Science, 21(12), 1693–1698. https://doi.org/10.1080/17461391.2020.1859621
Kelly, M. M., & Vogt, D. S. (2009). Military stress: Effects of acute, chronic, and traumatic stress on mental and physical health. In S. M. Freeman, B. A. Moore, and A. Freeman (Eds.), Living and Surviving in Harm’s Way: A Psychological Treatment Handbook for Pre- and Post-Deployment of Military Personnel (pp. 85–106). https://doi.org/10.4324/9780203893906.
Keltner, C. H., Kao, T.-C., Ahmed, A., & Mancuso, J. D. (2021). E-cigarette and dual product use as an emerging health threat to the US military. Tobacco Prevention & Cessation, 7(June), 43. https://doi.org/10.18332/tpc/135516.
Knapik, J. J., Steelman, R. A., Hoedebecke, S. S., Farina, E. K., Austin, K. G., & Lieberman, H. R. (2014). A systematic review and meta-analysis on the prevalence of dietary supplement use by military personnel. BMC Complementary and Alternative Medicine, 14(1), 143. https://doi.org/10.1186/1472-6882-14-143
Knapik, J. J., Trone, D. W., Austin, K. G., Steelman, R. A., Farina, E. K., & Lieberman, H. R. (2016). Prevalence, adverse events, and factors associated with dietary supplement and nutritional supplement use by US navy and marine corps personnel. Journal of the Academy of Nutrition and Dietetics, 116(9), 1423–1442. https://doi.org/10.1016/j.jand.2016.02.015
Knapik, J. J., Steelman, R. A., Trone, D. W., Farina, E. K., & Lieberman, H. R. (2022). Prevalence of caffeine consumers, daily caffeine consumption, and factors associated with caffeine use among active duty United States military personnel. Nutrition Journal, 21(1), 22. https://doi.org/10.1186/s12937-022-00774-0
Lambert, E. G., & Paoline, E. A. (2008). The influence of individual, job, and organizational characteristics on correctional staff job stress, job satisfaction, and organizational commitment. Criminal Justice Review, 33(4), 541–564. https://doi.org/10.1177/0734016808320694
Landon, L. B., Douglas, G. L., Downs, M. E., Greene, M. R., Whitmire, A. M., Zwart, S. R., & Roma, P. G. (2019). The behavioral biology of teams: Multidisciplinary contributions to social dynamics in isolated, confined, and extreme environments. Frontiers in Psychology, 10, 2571. https://doi.org/10.3389/fpsyg.2019.02571
Lieberman, H. R., Agarwal, S., Caldwell, J. A., & Fulgoni, V. L. (2020). Demographics, sleep, and daily patterns of caffeine intake of shift workers in a nationally representative sample of the US adult population. Sleep, 43(3). https://doi.org/10.1093/sleep/zsz240.
Linton, S. J., Kecklund, G., Franklin, K. A., Leissner, L. C., Sivertsen, B., Lindberg, E., Svensson, A. C., Hansson, S. O., Sundin, Ö., Hetta, J., Björkelund, C., & Hall, C. (2015). The effect of the work environment on future sleep disturbances: A systematic review. Sleep Medicine Reviews, 23, 10–19. https://doi.org/10.1016/j.smrv.2014.10.010
Little, M. A., Bursac, Z., Derefinko, K. J., Ebbert, J. O., Talcott, G. W., Hryshko-Mullen, A., & Klesges, R. C. (2016). Types of dual and poly-tobacco users in the US military. American Journal of Epidemiology, 184(3), 211–218. https://doi.org/10.1093/aje/kwv321
Lowe, C. J., Safati, A., & Hall, P. A. (2017). The neurocognitive consequences of sleep restriction: A meta-analytic review. Neuroscience & Biobehavioral Reviews, 80, 586–604. https://doi.org/10.1016/j.neubiorev.2017.07.010
Mabry, J. E., Camden, M., Miller, A., Sarkar, A., Manke, A., Ridgeway, C., Iridiastadi, H., Crowder, T., Islam, M., Soccolich, S., & Hanowski, R. J. (2022). Unravelling the complexity of irregular shiftwork, fatigue and sleep health for commercial drivers and the associated implications for roadway safety. International Journal of Environmental Research and Public Health, 19(22), 14780. https://doi.org/10.3390/ijerph192214780
Manchester, J., Eshel, I., & Marion, D. W. (2017). The benefits and risks of energy drinks in young adults and military service members. Military Medicine, 182(7), e1726–e1733. https://doi.org/10.7205/MILMED-D-16-00339
Matsangas, P., & Shattuck, N. L. (2020). Sleep quality, occupational factors, and psychomotor vigilance performance in the US Navy sailors. Sleep, 43(12), zsaa118. https://doi.org/10.1093/sleep/zsaa118.
McFadden, D. (1979). Quantitative methods for analyzing travel behavior of individuals: Some recent developments. In D. A. Hensher and P. R. Stopher (Eds.), Behavior Travel Modelling (pp. 1–42). London: Routledge. https://doi.org/10.4324/9781003156055 .
McLellan, T. M., Riviere, L. A., Williams, K. W., McGurk, D., & Lieberman, H. R. (2019). Caffeine and energy drink use by combat arms soldiers in Afghanistan as a countermeasure for sleep loss and high operational demands. Nutritional Neuroscience, 22(11), 768–777. https://doi.org/10.1080/1028415X.2018.1443996
Moriarty, D. G., Zack, M. M., & Kobau, R. (2003). The Centers for Disease Control and Prevention’s Healthy Days Measures — population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes, 1(1), 1–8. https://doi.org/10.1186/1477-7525-1-37
Mündel, T. (2017). Nicotine: Sporting friend or foe? A review of athlete use, performance consequences and other considerations. Sports Medicine, 47(12), 2497–2506. https://doi.org/10.1007/s40279-017-0764-5
Murkett, R., Rugh, M., & Ding, B. (2022). Nicotine products relative risk assessment: An updated systematic review and meta-analysis. F1000Research, 9(1225), 1225. https://doi.org/10.12688/f1000research.26762.2.
Mushtaq, N., Sarwar, Z., Kouplen, K., Ahmed, R., & Beebe, L. A. (2022). Association of cardiovascular disease risk factors with exclusive smokeless tobacco use among US males: Cross-sectional analysis of NHANES data 2003–2018. American Journal of Health Promotion, 8901171221141980. https://doi.org/10.1177/08901171221141980.
Nadeem, I. M., Shanmugaraj, A., Sakha, S., Horner, N. S., Ayeni, O. R., & Khan, M. (2021). Energy drinks and their adverse health effects: A systematic review and meta-analysis. Sports Health, 13(3), 265–277. https://doi.org/10.1177/1941738120949181
Nelson, J. P., & Pederson, L. L. (2008). Military tobacco use: A synthesis of the literature on prevalence, factors related to use, and cessation interventions. Nicotine & Tobacco Research, 10(5), 775–790. https://doi.org/10.1080/14622200802027123
Newhouse, P. A., Penetar, D. M., Fertig, J. B., Thorne, D. R., Sing, H. C., Thomas, M. L., Cochran, J. C., & Belenky, G. L. (1992). Stimulant drug effects on performance and behavior after prolonged sleep deprivation: A comparison of amphetamine, nicotine, and deprenyl. Military Psychology, 4(4), 207–233. https://doi.org/10.1207/s15327876mp0404_2
Nilan, K., McKeever, T. M., McNeill, A., Raw, M., & Murray, R. L. (2019). Prevalence of tobacco use in healthcare workers: A systematic review and meta-analysis. PLoS ONE, 14(7), e0220168. https://doi.org/10.1371/journal.pone.0220168
Nutt, D. J., Phillips, L. D., Balfour, D., Curran, H. V., Dockrell, M., Foulds, J., Fagerstrom, K., Letlape, K., Milton, A., Polosa, R., Ramsey, J., & Sweanor, D. (2014). Estimating the harms of nicotine-containing products using the MCDA approach. European Addiction Research, 20(5), 218–225. https://doi.org/10.1159/000360220
O’Callaghan, F., Muurlink, O., & Reid, N. (2018). Effects of caffeine on sleep quality and daytime functioning. Risk Management and Healthcare Policy, 11, 263–271. https://doi.org/10.2147/RMHP.S156404
O’Connor, R. J. (2012). Non-cigarette tobacco products: What have we learnt and where are we headed? Tobacco Control, 21(2), 181–190. https://doi.org/10.1136/tobaccocontrol-2011-050281
Palinkas, L. A., & Suedfeld, P. (2021). Psychosocial issues in isolated and confined extreme environments. Neuroscience and Biobehavioral Reviews, 126, 413–429. https://doi.org/10.1016/j.neubiorev.2021.03.032
Parry, D., Iqbal, S., Harrap, I., Oeppen, R. S., & Brennan, P. A. (2023). Caffeine: Benefits and drawbacks for technical performance. The British Journal of Oral & Maxillofacial Surgery, 61(3), 198–201. https://doi.org/10.1016/j.bjoms.2023.01.007
Patel, U., Patel, N., Khurana, M., Parulekar, A., Patel, A., Ortiz, J. F., Patel, R., Urhoghide, E., Mistry, A., Bhriguvanshi, A., Abdulqader, M., Mehta, N., Arumaithurai, K., & Shah, S. (2022). Effect comparison of E-cigarette and traditional smoking and association with stroke—a cross-sectional study of NHANES. Neurology International, 14(2), 441–452. https://doi.org/10.3390/neurolint14020037
Phan, L., McNeel, T. S., Jewett, B., Moose, K., & Choi, K. (2022). Trends of cigarette smoking and smokeless tobacco use among US firefighters and law enforcement personnel, 1992–2019. American Journal of Industrial Medicine, 65(1), 72–77. https://doi.org/10.1002/ajim.23311
Picano, J., Holland, A., Landon, L. B., & Antonsen, E. L. (2022). Psychological requirements of a lunar base crew. In P. Eckart & A. Aldrin (Eds.), Handbook of Lunar Base Design and Development (pp. 1–19). Springer International Publishing.
Pomeroy, D. E., Tooley, K. L., Probert, B., Wilson, A., & Kemps, E. (2020). A systematic review of the effect of dietary supplements on cognitive performance in healthy young adults and military personnel. Nutrients, 12(2), 545. https://doi.org/10.3390/nu12020545
R Core Team. (2021). R: A Language and environment for statistical computing. (Version 4.1) [Computer software]. Retrieved from https://cran.r-project.org.
Ran, L. S., Liu, W. H., Fang, Y. Y., Xu, S. B., Li, J., Luo, X., Pan, D. J., Wang, M. H., & Wang, W. (2021). Alcohol, coffee and tea intake and the risk of cognitive deficits: A dose-response meta-analysis. Epidemiology and Psychiatric Sciences, 30, e13 e13. https://doi.org/10.1017/S2045796020001183
Reifman, J., Kumar, K., Hartman, L., Frock, A., Doty, T. J., Balkin, T. J., Ramakrishnan, S., & Vital-Lopez, F. G. (2022). 2B-Alert web 2.0, an open-access tool for predicting alertness and optimizing the benefits of caffeine: Utility study. Journal of Medical Internet Research, 24(1), e29595. https://doi.org/10.2196/29595.
Revelle W. (2019). Psych: Procedures for psychological, psychometric, and personality research. [R package]. Retrieved from https://cran.r-project.org/package=psych.
Robbins, A. S., Fonseca, V. P., Chao, S. Y., Coil, G. A., Bell, N. S., & Amoroso, P. J. (2000). Short term effects of cigarette smoking on hospitalisation and associated lost workdays in a young healthy population. Tobacco Control, 9(4), 389–396. https://doi.org/10.1136/tc.9.4.389
Robertson, I. T., Cooper, C. L., Sarkar, M., & Curran, T. (2015). Resilience training in the workplace from 2003 to 2014: A systematic review. Journal of Occupational and Organizational Psychology, 88(3), 533–562. https://doi.org/10.1111/joop.12120
Roma, P. G., & Bedwell, W. L. (2017). Key factors and threats to team dynamics in long-duration extreme environments. In E. Salas, W. B. Vessey, and L. B. Landon (Eds.), Research on Managing Groups and Teams (Vol. 18), Team Dynamics Over Time: Advances in Theory, Methods, and Practice (pp. 155–187). Bingley, UK: Emerald Publishing Limited. https://doi.org/10.1108/S1534-085620160000018007.
Ross, J. K. (2009). Offshore industry shift work—health and social considerations. Occupational Medicine, 59(5), 310–315. https://doi.org/10.1093/occmed/kqp074
Russell, D. W., Russell, C. A., & Lei, Z. (2022). Development and testing of a tool to measure the organizational safety climate aboard US Navy ships. Journal of Safety Research, 80, 293–301. https://doi.org/10.1016/j.jsr.2021.12.012
Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & de Andrade, S. M. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS ONE, 12(10), e0185781. https://doi.org/10.1371/journal.pone.0185781
Samn, S. W., & Perelli, L. P. (1982). Estimating aircrew fatigue: A technique with application to airlift operations (Report No.: SAM-TR-82.21). Brooks Air Force Base (TX): USAF School of Aerospace Medicine. https://apps.dtic.mil/sti/pdfs/ADA125319.pdf.
Scott, A. J., Webb, T. L., Martyn-St James, M., Rowse, G., & Weich, S. (2021). Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Medicine Reviews, 60(101556), 101556. https://doi.org/10.1016/j.smrv.2021.101556
Shattuck, N. L., & Matsangas, P. (2015). Caffeinated beverage consumption rates and reported sleep in a United States navy ship. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 59(1), 696–700. https://doi.org/10.1177/1541931215591151
Shattuck, N. L., Matsangas, P., Moore, J., & Wegemann, L. (2016). Prevalence of musculoskeletal symptoms, excessive daytime sleepiness, and fatigue in the crewmembers of a US Navy ship. Military Medicine, 181(7), 655–662. https://doi.org/10.7205/MILMED-D-15-00279
Shriane, A. E., Ferguson, S. A., Jay, S. M., & Vincent, G. E. (2020). Sleep hygiene in shift workers: A systematic literature review. Sleep Medicine Reviews, 53(101336), 101336. https://doi.org/10.1016/j.smrv.2020.101336
Smith, E. A., & Malone, R. E. (2014). Mediatory myths in the U.S. military: Tobacco use as “stress relief.” American Journal of Health Promotion, 29(2), 115–122. https://doi.org/10.4278/Ajhp.121009-QUAL-491.
Smith, B. P., Browne, M., Armstrong, T. A., & Ferguson, S. A. (2016). The accuracy of subjective measures for assessing fatigue related decrements in multi-stressor environments. Safety Science, 86, 238–244. https://doi.org/10.1016/j.ssci.2016.03.006
Smith, A. P., Lane, A., Bloor, M. J., Allen, P. H., Burke, A., & Ellis, N. (2003). Fatigue Offshore: Phase 2. The Short Sea and Coastal Shipping Industry. Cardiff (UK): Seafarers International Research Centre.
Sonnentag, S., Cheng, B. H., & Parker, S. L. (2022). Recovery from work: Advancing the field toward the future. Annual Review of Organizational Psychology and Organizational Behavior, 9(1), 33–60. https://doi.org/10.1146/annurev-orgpsych-012420-091355
Tannenbaum, S., Mathieu, J., Levy, J., Watson, D., Maynard, T., Beard, R., Salas, E., Boyle, B., Cato, C., Berry, C., & Blue, S. (2022). The development and validation of an Army team resilience measure. Military Psychology, 36(1), 83–95. https://doi.org/10.1080/08995605.2022.2065154
Tattan-Birch, H., & Shahab, L. (2020). The psychobiology of nicotine vaping: Impact on addiction, cognition, mood, anxiety and appetite. In P. Murphy (Ed.), Psychobiological Issues in Substance Use and Misuse (pp. 265–288). Routledge. https://doi.org/10.4324/9780429296345.
Temple, J. L., Hostler, D., Martin-Gill, C., Moore, C. G., Weiss, P. M., Sequeira, D. J., Condle, J. P., Lang, E. S., Higgins, J. S., & Patterson, P. D. (2018). Systematic review and meta-analysis of the effects of caffeine in fatigued shift workers: Implications for emergency Medical Services personnel. Prehospital Emergency Care, 22(sup1), 37–46. https://doi.org/10.1080/10903127.2017.1382624
The jamovi project. (2023). Jamovi (Version 2.4) [Computer Software]. Retrieved from https://www.jamovi.org.
Toblin, R. L., Adrian, A. L., Hoge, C. W., & Adler, A. B. (2018). Energy drink use in U.S. service members after deployment: Associations with mental health problems, aggression, and fatigue. Military Medicine, 183(11–12), e364–e370. https://doi.org/10.1093/milmed/usy205.
Torquati, L., Mielke, G. I., Brown, W. J., Burton, N. W., & Kolbe-Alexander, T. L. (2019). Shift work and poor mental health: A meta-analysis of longitudinal studies. American Journal of Public Health, 109(11), e13–e20. https://doi.org/10.2105/AJPH.2019.305278
U.S. Department of Defense. (2023). 2021 demographics: Profile of the military community [cited 2023 December 30]. Available from: https://demographics.militaryonesource.mil/.
U.S. Government Accountability Office. (2021). Navy Readiness: Additional Efforts are Needed to Manage Fatigue, Reduce Crewing Shortfalls, and Implement Training (Report No.: GAO 21–366). Washington (DC): United States Government Accountability Office. https://www.gao.gov/products/gao-21-366
U.S. Navy. (2023). Mental Health Playbook (Version 1.0) [cited 2023 May 22]. Available from: https://www.mynavyhr.navy.mil/Portals/55/Support/Culture%20Resilience/Leaders_Toolkit/Mental_Health_Playbook_February_2023.pdf
van Amelsvoort, L. G. P. M., Jansen, N. W. H., & Kant, I. (2006). Smoking among shift workers: More than a confounding factor. Chronobiology International, 23(6), 1105–1113. https://doi.org/10.1080/07420520601089539
van den Berg, N. H., Michaud, X., Pattyn, N., & Simonelli, G. (2023). How sleep research in extreme environments can inform the military: Advocating for a transactional model of sleep adaptation. Current Psychiatry Reports, 25(2), 73–91. https://doi.org/10.1007/s11920-022-01407-3
Van Dongen, H. P. A., Maislin, G., Mullington, J. M., & Dinges, D. F. (2003). The cumulative cost of additional wakefulness: Dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep, 26(2), 117–126. https://doi.org/10.1093/sleep/26.2.117
Verster, J. C., & Koenig, J. (2018). Caffeine intake and its sources: A review of national representative studies. Critical Reviews in Food Science and Nutrition, 58(8), 1250–1259. https://doi.org/10.1080/10408398.2016.1247252
Weaver, S. R., Kim, H., Glasser, A. M., Sutfin, E. L., Barrington-Trimis, J., Payne, T. J., ... & Loukas, A. (2018). Establishing consensus on survey measures for electronic nicotine and non-nicotine delivery system use: Current challenges and considerations for researchers. Addictive Behaviors, 79, 203–212. https://doi.org/10.1016/j.addbeh.2017.11.016.
Williams, E. S., Konrad, T. R., Scheckler, W. E., Pathman, D. E., Linzer, M., McMurray, J. E., Gerrity, M., & Schwartz, M. (2001). Understanding physicians’ intentions to withdraw from practice: The role of job satisfaction, job stress, mental and physical health. In M. D. Fottler, G. T. Savage, and J. D. Blair (Eds.), Advances in Health Care Management, Vol. 2 (pp. 243–262). Emerald Group Publishing Limited. https://doi.org/10.1016/S1474-8231(01)02029-8.
Williams, M. A., Reddy, G., Quinn, M. J., & Millikan Bell, A. (2022). Toxicological assessment of electronic cigarette vaping: An emerging threat to force health, readiness and resilience in the U.S. Army. Drug and Chemical Toxicology, 45(5), 2049–2085. https://doi.org/10.1080/01480545.2021.1905657.
Wootton, R. E., Richmond, R. C., Stuijfzand, B. G., Lawn, R. B., Sallis, H. M., Taylor, G. M. J., Hemani, G., Jones, H. J., Zammit, S., Davey Smith, G., & Munafò, M. R. (2020). Evidence for causal effects of lifetime smoking on risk for depression and schizophrenia: A Mendelian randomization study. Psychological Medicine, 50(14), 2435–2443. https://doi.org/10.1017/S0033291719002678
Yu, L., Buysse, D. J., Germain, A., Moul, D. E., Stover, A., Dodds, N. E., Johnston, K. L., & Pilkonis, P. A. (2012). Development of short forms from the PROMIS™ sleep disturbance and Sleep-Related Impairment item banks. Behavioral Sleep Medicine, 10(1), 6–24. https://doi.org/10.1080/15402002.2012.636266
Zhao, Y., Richardson, A., Poyser, C., Butterworth, P., Strazdins, L., & Leach, L. S. (2019). Shift work and mental health: A systematic review and meta-analysis. International Archives of Occupational and Environmental Health, 92(6), 763–793. https://doi.org/10.1007/s00420-019-01434-3
Zuckermann, A. M., Williams, G. C., Battista, K., Jiang, Y., de Groh, M., & Leatherdale, S. T. (2020). Prevalence and correlates of youth poly-substance use in the COMPASS study. Addictive Behaviors, 107, 106400. https://doi.org/10.1016/j.addbeh.2020.106400
Acknowledgements
We thank the leadership and crews of the participating U.S. Navy ships for their dedication and contributions. We also thank Jillian Jarrett, John Allen, and the CNSF OSRI team for their skilled technical contributions.
Funding
This work was supported by internal funds from the U.S. Navy, Commander Naval Surface Forces.
Author information
Authors and Affiliations
Contributions
Conceptualization: DWR, PGR, CAR. Methodology: PGR, DWR, CAR. Investigation: DWR, PGR. Data Curation: PGR, CAR. Formal Analysis: PGR, CAR. Visualization: PGR, CAR. Writing—Original Draft: PGR, CAR, DWR. Writing—Review & Editing: PGR, CAR, DWR. Funding Acquisition: DWR.
Corresponding author
Ethics declarations
Declarations
This work was prepared as part of our official duties. Title 17, U.S.C §105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C §101 defines a U.S. Government work as work prepared by an employee of the U.S. Government as part of that person’s official duties. Neither the authors nor their family members have a financial interest in any commercial product, service, or organization providing financial support for this research. The authors are solely responsible for the preparation, conduct, writing, and submission of the manuscript. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Department of Defense, Department of the Navy, Leidos Inc., Rice University, Pepperdine University, Uniformed Services University, nor the U.S. Government.
Ethics Approval
This study was performed in accordance with the principles of the Declaration of Helsinki. The ASCAS was approved by the Naval Medical Center Portsmouth Institutional Review Board (project NMCP.2020.0051).
Consent to Participate
Informed consent was obtained from all individual participants included in the study.
Competing Interests
The authors have no relevant financial or non-financial interests to disclose.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Roma, P.G., Russell, C.A. & Russell, D.W. Stimulant Use in High-Stress Occupational Environments: Countermeasure or Counterproductive?. Occup Health Sci (2024). https://doi.org/10.1007/s41542-024-00180-4
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1007/s41542-024-00180-4