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Assessing Fitness for Military Enlistment: Physical, Medical, and Mental Health Standards
Recommendation 7-1: We recommend that DoD undertake a formal cost-performance trade-off analysis to determine whether a stricter standard for marijuana waivers would be justified on cost-effectiveness grounds.
Current Standards and Requirements
Cigarette smoking has periodically surfaced as an issue in the U.S. military. Historically the military has been seen as a safe haven for smokers, a place where smoking was not only accepted but often encouraged. As far back as 1898, when the Navy’s surgeon general threatened to ban cigarettes aboard ships, he was forced to back down because of a potential mutiny (Moyer, 2000; Patrone, 1996). By World War I, American soldiers began receiving tobacco rations, which were promoted by such military leaders as General John J. Pershing, commander of American forces in France (London, Whelan, and Case, 1996:40): “Tobacco is indispensable as a daily ration. We must have thousands of tons of it without delay. It is essential for the defense of democracy.”
The practice of tobacco rations ended in 1975. Military veterans are also familiar with the expression, “The smoking lamp is lit,” a centuries-old nautical term to indicate that smoking was permitted. For many years, military exchanges sold cigarettes with large price discounts, free from the warning labels required on cigarette packages sold in the civilian market (Evans, 1998).2
As it turned out, the smoking lamp was lit quite often in the military. This may help to explain why three-quarters of all military veterans have smoked, according to studies in the late 1990s (Harris, 1997).3 In 1996, DoD estimated that 448,000 active-duty members were smokers (32 percent of the total force), and that smoking costs DoD about $530 million annually in health expenses, along with $345 million in lost productivity. The Worldwide Survey of Substance Abuse Among Military Personnel indicated that the proportion of military members who smoked declined
Warning labels were not required on cigarettes sold or distributed through the military system until 1970, five years after the establishment of the requirement for products sold in civilian stores.
Although the Harris report suggests that this is higher than in the civilian sector, the National Household Survey on Drug Abuse reports a comparable rate of lifetime smoking for men 35 or older.