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Assessing Fitness for Military Enlistment: Physical, Medical, and Mental Health Standards
might be candidates for screening out because of their extremely high rates of early attrition.
Information on preservice smoking behavior is gathered during health screening. Since preservice smoking behavior is an attrition concern as will as a health concern, DoD might consider asking applicants about their smoking behavior during other phases of the application or enlistment process. Applicants who indicate that they smoke, or who are identified as possible smokers during screening or examination, might then be asked to complete a biodata questionnaire to determine if they fit in a high-risk category for first-term attrition. At this point, continued evaluation might be warranted to determine suitability for military service.
CONCLUSIONS AND RECOMMENDATIONS
While cigarette smoking is not permitted during basic and advanced training, smoking is commonplace during the first term, especially among men. However, smoking in the military is no more commonplace than in civilian populations of comparable ages. With respect to military performance, there is evidence that smoking before entry is associated with injury during basic training, probably arising from its adverse effects on numerous physiological characteristics. In addition, studies across all three Services show elevated attrition rates for smokers, although the degree of elevation differs appreciably among the Services, perhaps due to different definitions of the frequency and quantity of smoking. It is clear that screening out all smokers or even frequent smokers would not be feasible simply because of their prevalence. Since smoking is correlated with other recruit characteristics related to lower performance outcomes, further research might identify subgroups of recruits with a set of behavioral characteristics that justify higher priority on entry than other subgroups.
Recommendation 7-2: Further research is needed on the relationship between preservice smoking and military performance, including attrition and other indicators. The research should be conducted across the Services using the same definitions of frequency and quantity of smoking, and the correlates of smoking with other recruit characteristics should be studied. Studies should include the costs and benefits of policy and force management options for dealing with the issue of preservice smoking.