patients who are willing to try to quit.

Legislative support is essential for a comprehensive tobacco-control program in DoD and VA.

Congress should do the following:

  • Repeal the Veterans Health Care Act of 1992 (Public Law 102-585, §526) to allow VA health-care facilities to become completely tobacco-free.

  • Expand the 2009 National Defense Authorization Act Section 713, “Smoking Cessation Program Under TRICARE,” to include smokeless-tobacco cessation treatment.

  • Direct DoD to sell tobacco products at prices at least equal to and preferably greater than local civilian retail prices.

DoD and VA research contributes to identifying effective tobacco-control programs, particularly for special populations, such as those with mental-health and substance-abuse problems.

DoD and VA should develop and fund a joint comprehensive research plan on tobacco control in military and veteran populations.


The committee was struck by several gaps that might be filled with appropriate research by DoD and VA. Of critical importance is the lack of information in both organizations about the success of their tobacco-cessation programs, particularly long-term abstinence rates. Without such information, it is difficult to assess which programs are working for military personnel, retirees, their families, and veterans and what might be done to improve them.

Research should be addressed to finding healthy substitutes for tobacco as a stress and boredom reliever during deployment. Deployed personnel use more smokeless tobacco; DoD should fund research on the determinants of smokeless tobacco use, on its long-term health effects, and on interventions to reduce its use.

The VA has conducted considerable research on tobacco use by veterans who have mental-health disorders, particularly PTSD, but more work needs to be done. Research should focus on the timing of interventions and on the use and possible interactions of tobacco-

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