Panel suggests eliminating tobacco from military within 20 years
July 1, 2009
A complete ban on tobacco in the military is needed but would likely take about 20 years, according to a new Institute of Medicine study commissioned by the departments of Defense and Veterans Affairs.
The ban is possible if the DOD begins to "close the pipeline of new tobacco users entering the military" and slowly cuts off supplies of cigarettes and smokeless tobacco, the Committee on Smoking Cessation in Military and Veteran Populations found in its study, which was released Friday.
The DOD and VA asked the institute for recommendations on how to deal with smoking among servicemembers.
The study gives a bleak account of the health and financial toll tobacco takes on the military, which has nearly twice the smoking rate of the civilian population.
More than 30 percent of servicemembers smoke or use tobacco, though smokeless tobacco use is less certain. Those people are more likely to drop out of basic training, have poor vision, leave the service within the first year, get sick and miss work, according to the study findings.
The 15-member committee of doctors and health care professionals said the best way to reduce the problem is to eliminate it through a phased-in tobacco ban across the services.
First, officer academies and basic training should go smoke-free and enforce the rule through urine screening. Those who test positive for nicotine could be required to take smoking cessation therapy.
All services could be free of tobacco in 20 years — if the recruit screening begins within one year, the committee said.
The study also recommended that all military installations should move toward a ban on tobacco sales by barring Army and Air Force grocery stores from selling tobacco products and increasing prices at exchange stores. The Navy and Marine Corps already have stopped selling tobacco in their commissaries.
“At the same time that tobacco results in high health care costs and productivity losses for DOD, the department earns substantial net revenues from the sale of tobacco products in military commissaries and exchanges,” the committee wrote.
The conflict of interest has made changing tobacco sales policies difficult.
In 2005, the military sold $611 million worth of tobacco and $88 million was pumped back into community programs at military installations.
But those proceeds are dwarfed by the health care costs of treating sick smokers.
The military health system spent $564 million on smoking-related illnesses in 2006. The VA spent over $5 billion in 2005 to treat a common respiratory ailment that is caused by smoking, the study said.
Meanwhile, the military needs additional focus on smoking cessation programs, which are made available to servicemembers hoping to quit.
The NIH researchers said many in the DOD have avoided pressuring smokers deployed to war zones to enter smoking cessation programs, and they had trouble finding DOD documentation on whether those smoking cessation programs were helping people quit.
“This does not inspire confidence that the programs are meeting the needs of military personnel and it prevents contributions from outside personnel on how the programs might be improved,” researchers wrote.
The cessation programs should be improved and even deployed servicemembers must be encouraged to quit tobacco by commanders, the committee recommended.