• decreasing accessibility via increased pricing and restrictions on smoking areas and tobacco use (Goal C.1),

  • MHS identification of users and provision of targeted interventions (Goal D.1),

  • MHS provision of effective cessation programs (Goal D.2), and

  • continual assessment of best practices in tobacco-use prevention (Goal E).

In Chapter 4, the committee identified the key implementation components of a comprehensive tobacco-control program: a strategic plan, dynamic leadership, essential intervention components (enforceable and enforced policies, communication interventions, and evidence-based treatments), adequate resources, surveillance and evaluation of the program’s effectiveness, and management capability to adjust the program in response to that evaluation. The ATAC strategic plan covers many of those components: the strategic plan itself, policy review and development, public-relations activities, the use of evidence-based tobacco-cessation interventions, and surveillance and evaluation mechanisms. Furthermore, the plan requires specific policies on tobacco pricing and access, and it restricts when and where tobacco can be used on installations. In the following sections, the committee examines the progress that DoD has made toward achieving the goals set forth in the 1999 Tobacco Use Prevention Strategic Plan, identifies the gaps between the plan and the key program components of an evidence-based comprehensive plan as endorsed by the committee, and discusses actions that DoD can take to eliminate the gaps. The committee based its findings and recommendations on published instructions, directives, and other regulations or documents available publicly from the DoD ASD(HA) and each armed service.

Reducing Tobacco Consumption

Goal A.1 of the 1999 DoD Tobacco Use Prevention Strategic Plan seeks to reduce the smoking rate by 5%/year and the rate of the use of smokeless tobacco by 15% by 2001 from 1998 baseline rates. The goal was to be accomplished by establishing the AATURC to coordinate and monitor DoD progress on the prevention plan. An annual DoD survey of tobacco-use rate by active-duty personnel, National Guard and reserve personnel, DoD civilian employees, and TRICARE Prime enrollees was called for to determine progress. Populations at high risk for tobacco initiation, such as young military personnel and adolescent beneficiaries, were also to be identified. DoD established the AATURC, now the ATAC, which continues to provide recommendations on

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