Trajectories of alcohol use in the UK military and associations with mental health

•Group trajectories of alcohol use were examined in a representative military population.•A fifth of military personnel were in a heavy drinking class.•Across four of five classes alcohol use did not decrease over an 8 year period.•Mental health problems were more common in both heavy drinkers and abstainers.•Effective alcohol interventions are required for this population.

IntroductionThere are higher levels of alcohol misuse in the military compared to the general population. Yet there is a dearth of research in military populations on the longitudinal patterns of alcohol use. This study aims to identify group trajectories of alcohol consumption in the UK military and to identify associations with childhood adversity, deployment history and mental disorder.MethodsData on weekly alcohol consumption across an eight year period and three phases of a UK military cohort study (n = 667) were examined using growth mixture modelling.ResultsFive alcohol trajectory classes were identified: mid-average drinkers (55%), abstainers (4%), low level drinkers (19%), decreasing drinkers (3%) and heavy drinkers (19%). Alcohol consumption remained stable over the three periods in all classes, other than in the small decreasing trajectory class. Individuals in the heavy drinking class were more likely to have deployed to Iraq. Abstainers and heavy drinkers were more likely to report post-traumatic stress disorders at baseline compared to average drinkers.ConclusionsHeavy drinkers in the UK military did not change their drinking pattern over a period of eight years. This highlights the need to develop effective preventive programmes to lessen the physical and psychological consequences of long-term heavy alcohol use. Individuals with a mental health problem appeared more likely to either be drinking at a high level or to be abstaining from use.