Many military tobacco users eventually enter the VA health system or the DoD TRICARE system. Most tobacco-related diseases take years to develop, so these two health-care systems bear much of the burden of care, and each has a vested interest in assisting active-duty and retired military personnel and veterans in quitting the use of tobacco. The Institute of Medicine (IOM) was asked to conduct a study in response to DoD’s and VA’s need to determine what the medical and public-health records can document as best practices for reducing tobacco consumption by military and veteran populations.


DoD and VA asked IOM to convene a committee to recommend ways for the two agencies to work together to improve the health of active-duty and veteran populations with regard to tobacco-use initiation and cessation. The agencies asked that the committee consider the following:

  • Identify policies and practices that might by used by DoD and VA to prevent initiation of smoking and other tobacco use in the military.

  • Identify policies or potential barriers that might inhibit broader implementation of evidence-based tobacco-use cessation care in both DoD and VA.

  • Identify opportunities for increased access to evidence-based smoking and other tobacco-use cessation programs in VA and DoD.

  • Evaluate changes, including changes in policy, that could help to lower rates of smoking and other tobacco use in military and veteran populations.

  • Identify policies and practices that address unique tobacco-use prevention and cessation needs of special populations in DoD and VA, including those with psychiatric or substance-use disorders, those with chronic medical comorbidities, and women.

  • Recommend research approaches for reducing initiation of tobacco use and promoting tobacco-use cessation.

In response to that request, IOM convened the Committee on Smoking Cessation in Military and Veteran Populations, which wrote this report.

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