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ARLINGTON, Va. — If you gotta smoke, at least smoke American.

That’s one of several tips the Army’s Center for Health Promotion and Preventive Medicine recommends to all deployed troops, not just those in Iraq, in order to stymie illnesses, especially cases of pneumonia.

In recent months, roughly 100 troops serving in the Middle East have developed pneumonia, including 18 who suffered such serious bouts that they needed to be placed on ventilators.

Two of the 18 have tested positive for the bacteria streptococcus pneumonia, the most common cause of the bacterial cases, and another two died from pneumonia; their deaths are under investigation and have not been linked to the bacteria, officials have said.

While medical officials recommend not smoking at all, those who do at least should smoke American-made cigarettes, which are less powerful and more regulated than foreign-made ones, said Ann Ham, a spokeswoman for the Army’s health center.

“Because foreign cigarettes are different, they can cause health problems such as sore throats, colds, respiratory problems — a lot,” Ham said. “They tend to be stronger than American cigarettes and not as well-regulated by the [Food and Drug Administration.]”

Medical staff sent to Iraq and the Landstuhl Regional Medical Center in Germany are investigating the 18 severe pneumonia cases. No scientific link has been established between the cases and smoking, Ham said, and to focus on cigarette smoking alone skews the issue, she said.

Avoiding cigarettes is just one of many tips troops should practice in order to avoid illnesses, she said. According to posted recommendations on the Army health center’s Web site, troops deployed anywhere in the world should practice the following:

Stay hydrated.Don’t smoke! Cigarettes are dangerous.If you must smoke, smoke American cigarettes.Wash hands frequently.Use cravat or dust mask to reduce dust inhalation.Use wet mopping when cleaning dust in living and work areas.Seek medical care immediately if you have fever, chills and cough.The recommended list and other health information can be found on the Internet at: http://chppm-www.apgea.army.mil.

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