Installation Tobacco Control Programs in the U.S. Military

Abstract

Tobacco use prevalence is unacceptably high in the U.S. military, and the Department of Defense and service branches have implemented tobacco control policies and cessation programs. To explore aspects of programs regarded as exemplary by their services, we visited four installations, nominated by their service's health promotion leaders, and conducted interviews, observations, and focus groups. Installations included Naval Hospital Guam, Tripler Army Medical Center, MacDill Air Force Base, and the Naval Hospital at Marine Corps Air Ground Combat Center Twentynine Palms. The tobacco control managers (TCMs) at the programs studied were all civilian employees, highly motivated and enthusiastic, and had remained in their positions for approximately a decade. Other commonalities included support from command, a “culture” of health, and location in warm climates. Programs varied in their involvement in establishing designated tobacco use areas, and length and requirement of attending cessation classes; however, no evaluation of cessation programs is currently underway. TCMs should be more engaged in policy discussions for the larger installations they serve. A strong policy framework and command support for TCMs will be necessary to achieve the goal of a tobacco-free military.

Nicotine Dependence and Pre-Enlistment Suicidal Behavior Among U.S. Army Soldiers

“…Awareness of relationships of ND with suicidal behaviors may inform risk assessment and targeting of suicide prevention programs. The findings reinforce the importance of preventing ND; and imply that the military's efforts to reduce tobacco use 23 may benefit the mental as well as physical well-being of service members.…”

“…The availability of tobacco cessation interventions 22,23 implies that, if tobacco use/ dependence is a contributor to suicidal behavior, it is a modifiable one. Identifying modifiable risk factors for suicidal behavior is critical to efforts to reduce suicide in the Armed Forces, [24][25][26] and constitutes the overarching goal of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).…”

Veterans' Views on Military Tobacco Use and Tobacco Control Policy

“…Tobacco control policies in the military include tobacco-free basic training, smoke-free housing policies (these vary by service) (Smith, Rojo, & Malone, 2015), and tobacco cessation programs that include in-person and online elements, as well as availability of nicotine replacement therapy (details of these programs also vary by service and installation) (Smith, Poston, Haddock, & Malone, 2016). Most workplaces are smokefree.…”