Tobacco counteradvertising is a complex issue in the military and is not consistent among the services. DoD’s counteradvertising campaign “Quit Tobacco. Make Everyone Proud” includes a Web site, posters, games, and educational materials tailored to young military men. DoD tobacco-cessation activities conducted by health-promotion personnel include health fairs, Web sites, and other activities that raise the profile of tobacco cessation. The committee was unable to determine whether public-affairs staff are engaged in tobacco counteradvertising, but it noted that many of the armed services’ newsletters and Web sites contain articles on tobacco-control activities.
Reaching the goal of decreasing the accessibility and availability of tobacco products by pricing and tobacco-use restrictions will require actions beyond the authority of DoD. DoD does not have complete autonomy with regard to the pricing of tobacco products and is subject to congressional oversight on this issue. Tobacco products are offered at a discount in military commissaries and exchanges, and the committee believes that DoD should not subsidize an activity that adversely affects military readiness and health. The committee finds that DoD and the armed services have restricted tobacco use to designated areas on installations but believes that primary and secondary exposure to tobacco smoke could be reduced if the restrictions were extended to decrease the number of such areas, extend the tobacco ban from basic military training to technical training, and prohibit tobacco use in medical-treatment facilities.
The committee commends DoD for its efforts in identifying tobacco users. All of the armed services require that the VA/DoD Clinical Practice Guideline for the Management of Tobacco Use be used by health-care providers. The guideline, a joint effort of VA and DoD, is modeled on the 2000 PHS clinical-practice guideline Treating Tobacco Use and Dependence. It provides a military and veteran focus for tobacco-cessation interventions. All service members are to be asked about their tobacco status during their annual physical and dental examinations, and the information is to be included in the patients’ medical records. DoD’s success in providing targeted interventions to tobacco users is less clear. Although the guideline calls for health-care professionals to advise patients to quit tobacco use and at least refer them for treatment if they indicate willingness to make a quit attempt, adherence to this practice is not monitored. Targeted interventions are available and are described in the VA/DoD guideline. The treatment options used by the armed services are variable, and their long-term effect on abstinence rates in active-duty personnel or their families has not been evaluated.