Approximately one in three active duty service members uses tobacco, compared with one in five adult civilians.
In combat veterans, the number can be as high as one in two. This statistic amounts to several hundred thousand uniformed men and women who start and end their day with a smoke, dip or chew.
The health, financial, and operational readiness impacts of tobacco use in military personnel have garnered considerable attention over the last several years.
The consequences of tobacco use on health are painfully obvious.
Most Americans know of someone who has died of a smoking related disease such as lung cancer or emphysema.
However, smoking is also associated with other health conditions which many people are not aware.
Examples include coronary artery disease, heart attack, stroke and peripheral vascular disease. Health effects of smokeless tobacco are equally devastating. Prolonged use of smokeless tobacco can lead to esophageal, lip, and pancreatic cancer and heart disease.
The financial impact of tobacco use is staggering. Governmental accounting reports indicate that tobacco use costs the Pentagon close to a billion dollars per year in medical care and lost productivity.
The Department of Veterans Affairs spends around $6 billion annually in tobacco-related health costs. As far as the impact on readiness, one only needs to ask a senior Non-Commissioned Officer how smoking reduces stamina, endurance and efficiency in junior enlisted troops.
As an example of how high this issue has reached in the military chain of command, the Pentagon and VA requested that the Institute of Medicine (IOM) review the problem of tobacco use in the military.
A subsequent 2009 report by the IOM recommended a “phased-in” ban of tobacco use over a 20-year period. As you might expect, the recommendation was not well-received by the average “Joe” and “Jane.”
Consistent with America’s attempt at prohibition of alcohol in the 20’s and 30’s, the push to ban tobacco in the military was eventually dropped. However, there is a new “push” to ban tobacco use in the military.
“Smoking zones” are becoming fewer and far between on military posts and bases and some units have outright banned smoke breaks.
Tobacco use is as much a part of military culture and history as is saluting. From the vintage stories of cigarette rationing in World War I to the iconic image of the “Marlboro Marine” in Fallujah, “lighting-up” after a tough battle or stressful day is socially accepted, if not outright encouraged.
A Personal Decision
As a former Army officer, I would be the last to tell a service member that he or she should quit using tobacco. However, as a psychologist, I am acutely aware of the impact tobacco use has on the person and those around him or her as well as how difficult it is to quit.
The decision to stop using tobacco has to be a personal one. In my experience working with those trying to quit, the reasons vary. Some are because of an actual or fear of failing health, birth of a child, promise to a loved one or merely financial reasons.
“Kicking the habit” is not easy. It takes commitment, support, and failing a few times.
If you work with service members or veterans, or any patient that uses tobacco for that matter, you can help them deal with the psychological and physical dependence associated with tobacco use. Below are a few steps that can help them get started.
Step 1: Select your reason for quitting and decide how you will quit. This first step is likely the most important. Helping your patient identify why he or she wants to quit (money, family, health) and what resources he or she will use (cold turkey, nicotine gum or patches, behavioral counseling) will increase chances for success.
Step 2: Pick a quit date and use a savings calculator. Unless your patient picks a quit date, then he or she runs the risk of postponing the actual process of quitting. Humans are good at delaying difficult endeavors. Setting a firm date to kick the habit will better operationalize and cement the process.
Utilizing a savings calculator, especially if one of the reasons is to stop, will provide valuable information on how much money will be saved once the habit is kicked.
Step 3: Figure out what triggers you to use tobacco. If your patient can identify triggers for using tobacco then he or she will be more successful in reducing cravings. This, in return, will reduce his or her chances of smoking, dipping, or chewing.
Common triggers include eating, drinking alcohol, riding in the car and while hanging out with friends who smoke.
Step 4: Rally the support of unit members, friends and family. People are more successful when they elicit the support of those closest to them. Great resources in particular are loved ones and colleagues who have quit themselves.
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