Patterns and Impacts of Alcohol and Tobacco Use Among Male Medical Personnel in Sri Lankan Military Hospitals: A Multifaceted Assessment of Usage, Psychological Well-being, and Policy Effectiveness

Background: Operational effectiveness in military settings depends on maintaining optimal health among personnel. However, the demands and stressors of military life contribute to high-risk behaviours, particularly alcohol and tobacco use. This study examines the prevalence and determinants of these behaviours among Sri Lankan Army medical personnel. Objective: To determine the prevalence and associated factors of alcohol and tobacco use among male medical personnel in a Sri Lankan military hospital. Methods: A descriptive cross-sectional study was conducted among 424 male Army medical personnel selected through stratified random sampling. Data were collected using validated, pretested self-administered questionnaires. Descriptive statistics were used to summarize frequencies and percentages. Associations were examined using chi-square tests, and effect sizes were calculated using Phi and Cramer’s V. Data analysis was performed using SPSS version 26. Results: Participants had a mean age of 36 years, with most aged 31–40 and married. Alcohol use was reported by 42.9%, while tobacco use was low (6.6%); nearly half abstained from both. Substance use was significantly associated with age and home location but not with education or rank. Depression and Post Traumatic Stress Disorder (PTSD) were strongly correlated, and alcohol use showed a moderate association with depression, where as nicotine dependence was not linked to mental health outcomes. Although policy awareness was high, perceived effectiveness was limited, and gaps in access to prevention programs were evident. Conclusion: Alcohol use is common among military medical personnel, while tobacco use is low. Its association with depressive symptoms highlights the influence of psychological stress. Despite high policy awareness, limited perceived effectiveness indicates the need to strengthen policies, mental health services, and prevention programs to support a healthier military healthcare workforce.