ObjectiveSuicides among active duty US Army personnel have been increasing since 2004, surpassing comparable civilian rates in 2008. This analysis uses US military data to assess suicide rates for the 2-year period 2007–8, and examines relative risks (RR) of suicide associated with mental health disorders.MethodsHistorical trends of US Army suicides were assessed using 1977–2008 data from Army G-1 (Personnel). Suicide rates, RR and the 2000–8 trends of mental health disorders were calculated using data from the Defense Casualty Information Processing System and Defense Medical Surveillance System.ResultsA total of 255 soldiers committed suicide in 2007–8 (2008 rate 20.2 per 100 000). Factors associated with higher suicide risk included male gender, lower enlisted rank and mental health disorders treated on an outpatient basis (RR 3.9), as well as a number of mental health disorders (mood disorders, anxiety disorders, post-traumatic stress disorder, personality/psychotic disorders, substance-related disorders and adjustment disorder; RR range 4.7–24.5). Analysis of historical trends suggested that 25–50% of the suicides that occurred in 2008 might have been related to the major commitment of troops to combat beginning in 2003.ConclusionsThe recent increase in suicides parallels an increase in the prevalence of mental disorders across the army. This finding suggests that increasing rates of clinically treated psychopathology are associated with increasing rates of suicides; these rates probably serve as sentinels for suicide risk in this population. Soldiers seeking treatment for mental disorders and substance abuse should be a focus for suicide prevention.

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Campaigns to limit tobacco use started in the 1970s and have led to bans on public smoking, which have been extended to parks and beaches. A review of state and local statutes shows that during 1993-2011, smoking was banned in 843 parks and on 150 beaches across the United States. Three justifications for these restrictions have been invoked: the risk of passive smoke to nonsmokers, the pollution caused by cigarette butts, and the long-term risks to children from seeing smoking in public. Our analysis of the evidence for these claims found it far from definitive and in some cases weak. What, then, accounts for the efforts to impose such bans? We conclude that the impetus is the imperative to denormalize smoking as part of a broader public health campaign to reduce tobacco-related illness and death. Although invoking limited evidence may prove effective in the short run, it is hazardous for public health policy makers, for whom public trust is essential.

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