Narrowed smoker discounts still seen as unhealthy
The Department of Defense website, ucanquit2.org, offers a free online support system that prepares tobacco users to quit the habit, using interactive components such as quit tools, self-assessment questionnaires, quizzes and activities.
Military discounts on cigarettes sold at base exchanges narrowed by half over past two years but remain “substantial” and contradictory of health policies of the Department of Defense, according to a new analysis of cigarette pricing on base in this month’s American Journal of Public Health.
The survey results add momentum to a plan being eyed by Navy Secretary Ray Mabus to pull tobacco products from all Navy and Marine Corps exchanges and commissaries as well as ship stores by fall of this year.
Defense Secretary Chuck Hagel gave that idea a kind of gentle endorsement this week when he said servicemembers’ health has to be viewed as a higher priority than any hit to troop morale caused by the potential loss of easy access to discounted tobacco.
“I think you start with [a] look at the health of your force,” Hagel said. “I don't know if there's anybody in America who still thinks that tobacco's good for you…The Surgeon General 50 years ago made that statement pretty clear. We don't allow smoking in any of our government buildings, restaurants. States and municipalities have pretty clear regulations on this.”
Whether bases should “continue to sell tobacco is something we need to look at and we are,” said Hagel. “We owe it to our people. The health care costs are astounding, well over a billion dollars just in the Department of Defense on tobacco-related illness and health care.”
Hagel’s remarks capture the theme of a March 14 memorandum to the services from Dr. Jonathan Woodson, assistant secretary of defense for health affairs, who recounted the ways tobacco use “undercuts military readiness and harms individual performance.”
Yet the “prominence of tobacco products in [military] retail outlets, and permission for smoking breaks while on duty, sustain the perception that we are not serious about reducing the use of tobacco.”
“Our goal,” Woodson said, “is to dramatically reduce the use of all tobacco by 2020. Individual military communities are taking action to curtail tobacco use, but we must develop more aggressive, organization-wide reforms. Structural reforms in how and where we allow tobacco purchases to be made, as well as the need to consider tobacco-free installations, are all matters that require our near-term attention.”
The new survey on base tobacco prices by the Institute for Biobehavioral Health Research of Leawood, Kansas, compares what exchanges charged in 2013 for a pack of Marlboro Red, by far the most popular brand of cigarette, to prices at nearby Walmart stores. Price data gathered in 2013 were then compared to data collected in 2011.
Results show discounts on cigarettes had narrowed from average savings of 24.5 percent at exchanges in 2011 to 12.5 percent last year.
Much of that occurred, however, because Walmart dropped prices significantly. Exchanges raised prices only modestly and some just ignored or found ways to get around Defense Department policy language that tobacco discounts are not to be “lower than 5 percent below the most competitive price in the local community.”
In a phone interview, Christopher Keith Haddock, co-author of the survey report, described military smokers as a “uniquely important niche market” for tobacco manufacturers.
“People admire the people who defend our country,” said Haddock. “They are seen as fit, virile. And if they smoke, how could tobacco be all that bad? That’s very important to the tobacco industry.”
As a result, when past service leaders have announced goals to be smoke free by a date certain, the tobacco lobby applied lots of political pressure on both the Department of Defense and on the Congress.
In 2012 the Navy Department directed its stores to raise cigarette prices to be level with the most competitive local prices, removing the extra five percent discount allowed by DOD instruction.
That initiative did account for much of the narrowing of overall discounts the last two years. However, even Navy and Marine Corps exchanges into 2013 continued to sell Marlboro Red more than eight percent cheaper, on average, than local Walmarts. Exchanges on Army bases set cigarettes prices an average of 17 percent below Walmart prices and stores on Air Force bases reported average discounts of 14 percent.
Across 172 exchanges where price comparisons with Walmart were successfully made, the results showed only 4.9 percent of exchanges had set cigarette prices within 5 percent of Walmart prices. And at some exchanges, DOD price guidance seemed largely ignored.
For example, the base store at West Point Military Academy in New York in 2013 sold Marlboro Red packs for $5.80, half the price of $11.73 charged at the local Walmart. The same brand also sold for $5.80 at Hanscom Air Force Base, Maine, but that was 37 percent below the local Walmart price. At Maxwell-Gunter Air Force Base in Alabama, that pack sold for $4.40 on base, two dollars cheaper than at Walmart.
Such “surprisingly large” discounts “actively encourage tobacco consumption by our nation’s troops,” the study found. “Although prices increased modestly at exchanges across the study period, they remained relatively low compared with a civilian discount chain.”
Not only has DOD price guidance not been rigidly or uniformly applied, it fails to address exemptions from state and local taxes for goods sold on base. Thus tobacco discounts can remain significant, fueling exchange profits. Those profits, in turn fund morale, welfare and recreational (MWR) activities offered on base, from golf courses to gymnasiums.
With 25 percent of servicemembers self-identified as smokers, a rate considerably higher than civilian peers, discounts contradict the message of the military health community that smoking is detrimental to individuals and to overall force readiness, the survey authors concluded.
To become an “effective partner in the military’s tobacco control program, they said, “military retail outlets should go beyond simply controlling prices and follow the example of Veterans Affairs facilities, which phased out tobacco sales entirely.”