it easier to remain tobacco-free. That is echoed in the voice of young recruits who voiced their views toward tobacco policy: “If you want us to quit smoking, tell us we cannot smoke” (Peterson et al., 2003).

Studies have shown that point-of-sale promotions of tobacco products can increase impulse buying (Carter et al., 2009) and result in recent ex-smokers’ having urges to resume tobacco use (Paynter and Edwards, 2009). Furthermore, because of the framing issues described above, several practices now in place for some military personnel may induce greater consumption of cigarettes. For example, how tobacco products are displayed varies widely even among vendors on a single military base. Some exchanges promote cigarette sales with “power walls” (large portions of wall space devoted to promotional materials and the display of tobacco products) without any smoking-cessation products placed nearby (Hawthorne, 2008). In contrast, some commissaries that sell tobacco products place them in a separate section of the store enclosed in a cage-like structure and display telephone numbers for tobacco quitlines and promotion of smoking-cessation products prominently in the same location. Aside from the fact that enclosing tobacco products in a separate structure makes them harder to access and thus creates a physical barrier to purchase, the normative message sent by such a display differs greatly from that sent by a power wall. The cost of changing the display of tobacco and smoking-cessation products is low. Similarly, the procrastination that results from present-biased preferences is one reason why proactive quitlines may be more effective than passive quitlines. Such a policy incurs no cost to the people using the quitlines, but it may help them to quit. Similarly, when nicotine-replacement therapy is part of an appropriate treatment plan for smoking cessation, it should be made available with as few barriers as possible. People respond more than is “rational” to the delay in filling a prescription created by waiting for an hour at the pharmacy or when they need to fill out paperwork to obtain mail-order prescriptions. In summary, there are many ways in which leaders in DoD and VA could make relatively small changes in policy to exploit what we have learned from behavioral economics to reduce tobacco use (Hawthorne, 2008).

Geopolitical Context

The United States is engaged in two major military conflicts—OEF began October 2001 in response to the terrorist attacks of September 11, 2001, and OIF began in March 2003 when US-led coalition forces invaded Iraq. DoD reported that as of September 30, 2008, 45,700 military personnel were deployed to OEF and 380,800 to OIF (DoD, 2008).



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