Medical experts say they have a solution for the military’s increasing smoking rates:
Ban it.
And not just in basic training — stop selling cigarettes and chewing tobacco on post, stop with the discounts at the PX, don’t allow it in hospitals, and come up with a deadline when everyone should be smoke-free.
Why? It cost the Veterans Affairs Department $5 billion to treat smoking-related emphysema in 2008, and in 2006, the Military Health System spent about $564 million on tobacco-related costs.
That’s almost as much as the $611 million worth of tobacco military stores sold in 2005.
According to the Committee on Smoking Cessation in Military and Veteran Populations, in a report from the Institute of Medicine of the National Academies, the math just doesn’t add up for an organization that depends on physical fitness from its employees.
It’s not just money. Smokers are more likely to drop out of the military before they fulfill their enlistment commitments; they have worse vision and night-vision; they don’t perform as well on fitness tests; and they miss more work.
On the battlefield, they bleed harder after surgery, heal slower after injury and are at higher risk for infection.
After deploying to Iraq or Afghanistan, smokers return home only to face a startling statistic: About half of them will eventually die from a smoking-related illness, according to the Institute of Medicine report. They face cancer, stroke, heart disease, emphysema and diabetes.
“These troops are essentially putting their lives at risk twice: once in service to their country and once in service to tobacco,” wrote Stuart Bondurant, chair of the committee. “Tobacco is a long-term engagement — it kills slowly and insidiously.”
Even the good news was mixed with bad: In 1980, 51 percent of the military smoked. That had dropped to 32 percent in 2005, but it has been going back up. In the VA health system, 22 percent of patients smoke.
Though the committee determined both the Defense Department and VA are doing some things right — such as anti-smoking campaigns and, for the VA, smoking-cessation programs — they’re far behind on other measures.
“DoD and each of the armed services have a stated goal of a tobacco-free military, but tobacco-control efforts have not been given high priority by the Office of the Assistant Secretary of Defense for Health Affairs or the individual services’ Office of the Surgeon General,” the report states. And, “The committee believes that DoD should not subsidize an activity that adversely affects military health and readiness.”
In other words, why are cigarettes cheaper on-post?
The committee acknowledged that the military and VA face special challenges: Troops tend to take up smoking when they deploy, and cigarettes are highly addictive. That means they’re less likely to stop when they get home. In fact, 50 percent of smokers attempt to stop every year, but only between 4 and 7 percent succeed.
And, people with depression or post-traumatic stress disorder are more likely to smoke.
“That is of concern, given the increased numbers of veterans returning from the conflicts in Iraq and Afghanistan with PTSD and the number of Vietnam veterans who have PTSD,” the report states.
The committee recommended:
• Making sure troops and veterans know that smoking-cessation programs exist.
• Making sure those programs are consistent and evidence-based.
• Making VA and military health-care facilities smoke-free.
• Banning smoking in military academies, officer candidate schools and Reserve Officer Training Corps programs.
• Eliminating the sale of tobacco at all military installations
• Setting a specific, mandatory date by which the military will be tobacco-free.