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American troops who have been deployed to Iraq or Afghanistan – especially those who have been in combat – are more likely to start using smokeless tobacco, when compared to their counterparts who stay home, Reuters reports.

The new findings are on par with previous studies that have linked deployment and participation in combat to increased health risks, including higher rates of smoking and drinking alcohol, according to a new study published in the journal Addiction.

Of more than 45,000 troops surveyed from 2001 to 2006, two percent reported they began using smokeless tobacco during that time period, while another nine percent who had already developed the habit continued using.

Overall, the study found that troops who were deployed, but did not see combat were almost one-third more likely to take up a smokeless tobacco habit than their non-deployed counterparts. Those odds were two-thirds to three-quarters higher for troops who were in combat or who were deployed multiple times.

Fewer than four percent of all troops had symptoms of post-traumatic stress disorder (PTSD) and this cohort was 54 percent more likely to start using smokeless tobacco than troops without PTSD symptoms.

The data do not explain why some troops begin using smokeless tobacco after deployment, though study researchers suspect stress is a contributing factor.

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