Toward tobacco-free troops

The Pentagon recently announced a force reduction of 80,000 troops. Defense Secretary Leon Panetta said the new military will need to be “smaller, leaner, but agile and flexible.”

But how do we achieve an agile and flexible force when 30 percent of the force may be off-duty for several days because of illness related to tobacco use? How can we reliably deploy a ready force when a service member’s job performance is reduced because he or she is suffering from the physical effects of tobacco use? Can we afford to continue current policies such as selling tobacco at a discount in our military exchanges?

As a family nurse practitioner and registered nurse for 22 years, I have witnessed the effects of tobacco use on active-duty service members, their families and veterans during the course of my military career.

I particularly remember a gentleman in his late 50s who pulled me aside when I was a new 2nd lieutenant and registered nurse working on a busy cancer unit at Madigan Army Medical Center in Tacoma, Wash. The man was upset and wanted to talk about his lung cancer, his addiction to tobacco and his advice to future generations of service members.

He asked me to “tell the young people not to smoke, not to use tobacco, it has ruined my life, I am dying, it isn’t worth it, it just isn’t worth it.” He died several months later, and although I remember him clearly, I really didn’t know what to do with his message – until now.

I recently had a chance to review some startling information on the effect of tobacco use on military readiness. For starters, soldiers who use tobacco have reduced night vision and mental sharpness and are at an increased risk of heat and cold injuries. Nicotine decreases oxygen in the bloodstream, resulting in a 30 percent reduction in night vision for normal eyes and a 50 percent reduction in those wearing corrective lenses.

Imagine the potential dangers to a deployed service member and his or her team conducting night operations.

In addition to the physical effects, tobacco use is linked to higher rates of absenteeism, lost productivity, increased health care costs and early discharge in the first year of military service. The Department of Defense estimates that it spends about $1.6 billion a year on smoking-related illnesses and that the Veterans Administration spends more than $5 billion a year to treat veterans who smoke.

Smoking is also one of the behaviors that contribute to early discharge of service members during their first year of service. These early discharges cost taxpayers more than $130 million a year in lost training expenses.

The Department of Defense, Army, Air Force, Navy and Marines have battled tobacco use in the military by implementing comprehensive tobacco-control programs; however, tobacco use rates among service members continue to be 10 percent higher than the civilian sector. Thirty percent of service members smoke and almost 15 percent use smokeless tobacco.

One possible solution is to stop selling tobacco products at a cheaper price to service members.Currently, Department of Defense directive 1330.9 allows military exchanges to sell tobacco prices at “no lower than 5 percent below the most competitive commercial price in the local community,” and exchange purchases are free from state or local tobacco taxes.

This means that tobacco users may be able to purchase tobacco products at greater than a 5 percent discount from military exchanges. Raising the price of tobacco has been shown to decrease tobacco use in younger service members.

In addition to raising tobacco prices, we also must continue to invest in prevention programs that keep our young service members from using tobacco as well as health-promotion programs that help tobacco users kick this highly addictive habit.

We must make the consequences of tobacco use equal to other health choices faced by service members, such as being overweight, failing the physical fitness test or drinking while driving. A smaller, leaner, but agile and flexible military needs to be healthy in order to deploy anywhere and anytime. For that to happen, our military needs to be tobacco-free.

Edward E. Yackel is a colonel in the Army Nurse Corps and a doctoral student at the Duke University School of Nursing. His views are his alone and do not reflect the official policy of the Department of Army, Department of Defense or U.S. government.


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