considerably greater latitude to include cessation of tobacco use, not only smoking, in TRICARE’s benefit package.

In 1999, the DoD Prevention, Safety, and Health Promotion Council (PSHPC) established the Alcohol Abuse and Tobacco Use Reduction Committee (AATURC), now the Alcohol and Tobacco Advisory Council (ATAC), to provide advice on policies related to the supply, responsible use of, and the demand for alcohol and tobacco products (DoD, 1999). ATAC recommendations are given to the DoD Medical Personnel Council for consideration. ATAC members represent the services’ alcohol, substance-abuse, and health-promotion programs, their medical departments, the DoD Office of Personnel and Readiness, the DoD Office of the Chief Medical Officer, and a number of other DoD offices with an interest in alcohol and tobacco policy (DoD, 2007). The committee believes that between 1999 and 2001 the ATAC had been making good progress in addressing tobacco use in DoD. However, perhaps understandably, the high interest in, and impact of, this committee seems to have diminished since the terrorist attacks on America in 2001 as the US military addressed higher priorities. Nevertheless, over the long term, tobacco use poses one of the primary risks to the health and readiness of US military forces, and a plan must be established for once again assigning high priority to tobacco use with respect to health in DoD.

TOBACCO-CONTROL PROGRAMS IN THE DEPARTMENT OF DEFENSE

The MHS strategic plan for 2008 cites the military tobacco-use rate as a mission element for achieving healthy and resilient personnel, families, and communities. In 1999, the ATAC developed a Tobacco Use Prevention Strategic Plan that outlined goals and tasks; metrics and objectives; requirements for policy, programs, practices, and resources; and a timeline for achieving the goals (see Appendix B for the entire 1999 strategic plan). The plan, which is still in effect but has not been updated in 10 years, has the following goals:

  • reducing the smoking rate by 5%/year (Goal A.1),

  • reducing the smokeless-tobacco-use rate by 15% by 2001 (Goal A.1),

  • promoting a tobacco-free lifestyle and culture through education and leadership (Goal B.1),

  • educating commanders on how best to encourage healthy lifestyles (Goal B.2),

  • promoting the benefits of nonsmoking and providing tobacco counteradvertising (Goal B.3),



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