Combat Readiness, Harm Aversion, and Promotion Eligibility: A Qualitative Study of U.S. Servicemembers Views on Tobacco Use and Control in the Military

Abstract

This qualitative study identifies military-specific themes from the tobacco user perspective that help to guide research and policy in reducing tobacco use among military servicemembers. Possible interventions suggested by our findings may include replacing tobacco breaks with fitness breaks to relieve workplace stress and support the culture of fitness, expanding the use of pharmacologic stimulants to replace tobacco when used to maintain alertness, and gathering social support for tobacco cessation from non-healthcare unit members. Further study is needed to elucidate the effectiveness of proposed interventions suggested by our findings, with the ultimate aim of policy changes within the military to optimize health and military readiness, while decreasing long-term health effects and costs of tobacco use.

I smoke to cope with pain: patients’ perspectives on the link between cigarette smoking and pain

“…Tobacco smoking has been hypothesized to help people cope with stress by relieving negative affect, [32][33][34] and some qualitative studies revealed that in military culture, tobacco smoking is viewed as a form of stress relief [35][36][37]. The idea of smoking as "taking a break" is common as well [38], especially for military members undergoing rigorous training in the service [35][36][37]39]; however, research shows that, in reality, tobacco users tend to report having more stress than non-smokers and that smoking largely relieves the stress of nicotine addiction [40,41]. Coaching people who smoke about adaptive coping strategies to promote both smoking cessation and pain self-management can improve pain-related anxiety and lead to increased confidence in ability to quit [42].…”

Role of procedural intervention and acute illness in veterans affairs smoking cessation program referrals: A retrospective study

“…For veterans, the 2019 smoke-free policy signifies a profound shift in the culture of the VHA. Despite declining rates of civilian smoking 10 , a recent qualitative analysis of U.S. Marines revealed that many service men and women perceive tobacco use as a fundamental 'right' and praise the stimulant qualities of tobacco as advantageous to the rigorous demands of their work 13,14 . This sentiment is hardly surprising when taken in historical context.…”