tobacco policies and programs to the OASD(HA) through the PSHPC. The ATAC does not appear to have conducted smaller studies of tobacco use in select DoD populations; however, the DoD Survey of Health-Related Behaviors Among Military Personnel is conducted periodically (the latest survey for which data are publicly available was conducted in 2005) and reports on tobacco use by active-duty personnel (DoD, 2006). The survey does not include National Guard or reserve personnel, civilian employees, TRICARE Prime enrollees, or high-risk groups, so it is difficult to assess the full extent of the impact of the DoD tobacco-control program on all target populations.

Finding: DoD does not survey tobacco use by all beneficiaries of the MHS, including all TRICARE beneficiaries.

Recommendation: DoD should undertake such a survey to help to determine the needs of military personnel and their dependents for tobacco-control interventions.

Tobacco-Control Programs in the Armed Services

Independent tobacco-control programs have been developed by the armed services. The Army Health Promotion Program (AHPP) includes a tobacco-control component (Army Regulation 600-63, 2007). The program states that commanders and supervisors will encourage antitobacco activities in family members and retirees; that health-care providers will ask, advise, and assist patients with cessation information (3 of the 5 A’s described in Chapter 4); and that commanders at all levels will “demonstrate positive efforts to deglamorize the use of all forms of tobacco products.” Army installations are also directed to provide tobacco-cessation programs and, if they are not available on an installation, to coordinate such programs with local community resources. The Navy and Marine Corps Tobacco Policy (SECNAV Instruction 5100.13E, July 31, 2008) also details when and where tobacco may be used by naval personnel on installations (including housing; morale, welfare, and recreation (MWR) facilities; ships; and submarines), restricts the promotion of tobacco products, and stipulates that tobacco users should have access to tobacco-cessation treatment either on their installations or through referral to community resources. The Marine Corps, which has health-promotion personnel from the Navy, has incorporated the Navy requirements into base orders for those programs. For example, Base Order 6200.2C, “Tobacco Use Prevention Program for Camp Pendleton” (November 1993), and Base Order

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