• Provide all DoD and VA staff and patients with barrier-free access to tobacco-cessation services.

  • Ensure that there are adequate resources, including infrastructure and funding, at all facilities.

  • Inventory tobacco-cessation programs at each military installation and DoD and VA medical facility, and ensure that a trained tobacco-cessation counselor is available in each facility.

  • All DoD and VA health-care providers, including counselors, should be able to provide brief counseling and nicotine-replacement therapy to patients.

  • Report publicly and regularly on the performance of their tobacco-control programs, adherence to clinical-practice guidelines, and tobacco-cessation rates.

DoD and VA have established many best practices in tobacco cessation. Widespread adoption of the practices is essential for predictable and consistent tobacco-cessation services in DoD and VA.

The VA/DoD Clinical Practice Guideline for the Management of Tobacco Use should be updated and harmonized with the PHS clinical-practice guideline on tobacco management.


DoD and VA should develop and implement standards for the content and evaluation of tobacco-cessation counseling.

There is a strong association between tobacco addiction and mental-health problems, including anxiety disorders (such as PTSD), mood disorders (such as depression and bipolar disorder), schizophrenia, and substance abuse (alcohol and illicit drugs).

DoD and VA should follow the VA/DoD and PHS guidelines for treating tobacco use in patients who have mental-health disorders.

Mental-health professionals should receive training in tobacco-cessation treatment and provide assistance to any

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