Perspectives of US military commanders on tobacco use and tobacco control policy

Abstract

Background Tobacco use among U.S. military service members is unacceptably high, resulting in substantial health care and personnel costs. Support of military command is critical to the success of tobacco control policies because line commanders are responsible for implementation and enforcement. This study is the first to examine U.S. military line commander’s perspectives about current tobacco control policies and the impact of tobacco on readiness. Methods We conducted key-informant interviews with 20 officers at the U.S. Army’s Command and General Staff College about military tobacco use and tobacco control policy. Results Participants identified the long term impact of tobacco use on military members, but were unaware of proximal effects on health and readiness other than lost productivity due to smoke breaks. Officers also discussed nicotine addiction and the logistics of ensuring that an addicted population had access to tobacco. Regarding policy, most knew about regulations governing smoke-free areas and were open to stronger restrictions, but were unaware of current policies governing prevention, intervention, and product sales. Conclusions Findings suggest that strong policy that takes advantage of the hierarchical and disciplined nature of the military, supported by senior line and civilian leadership up to and including the Secretaries of the services and the Secretary of Defense, will be critical to substantially diminishing tobacco use by military personnel.

Cheaper tobacco product prices at US Air Force Bases compared with surrounding community areas, 2019

“…However, targeted marketing by the tobacco industry through price promotions and discounted tobacco products on military bases has likely contributed to the high rates of tobacco use among this priority population 15–22. In fact, junior enlisted military personnel perceive that the military actually supports tobacco use by providing reduced tobacco prices in stores on base,23–26 even though a 2017–2018 study found trainees who smoked were about as likely to buy their cigarettes on base as off base (24.8% vs 28.7%, respectively) 27. In 2005, the DoD issued Instruction 1330.09, which required retailers on military installations to set tobacco product prices to be no cheaper than 5% lower than the most competitive price in the local community 28…”