prevention of tobacco use in military personnel and veterans as well as on whether and how tobacco users are supported in their cessation efforts. The committee summarizes its observations on those issues below and then looks at synergies between DoD and VA that can be used to enhance tobacco-control activities in both organizations.

TOWARD A TOBACCO-FREE MILITARY POPULATION

The idea of establishing a tobacco-free military is not novel. There are numerous reasons why the military would support the goal of becoming tobacco-free, such as improved military readiness, better health of the force, and decreased health-care costs. The US military has set goals to become tobacco-free several times (Arvey and Malone, 2008). Those goals were not reached, but the efforts highlight the military’s interest in achieving a tobacco-free force. The committee finds that a comprehensive tobacco-control program that combines prevention efforts with restrictions on tobacco use and sales, increases tobacco prices, incorporates a counteradvertising campaign to change social norms around tobacco use, and provides easy access to tobacco-cessation interventions based on best practices would be the most effective approach for helping DoD to achieve a healthier, tobacco-free military.

The committee believes that the most realistic plan for reaching the long-term goal of a tobacco-free military is a phased approach that requires policy changes to close the pipeline of new tobacco users entering the military. As people enter active-duty military service through basic training and officer-commissioning programs, they become part of a pipeline of service members who will then enter advanced military training and technical-school training and eventually meet a projected personnel need. Over 300,000 enlisted personnel are recruited into the military each year. The committee encourages each armed service, and DoD as a whole, to establish a timeline to end tobacco use in new officer and enlisted accessions into the military.

The armed services are encouraged to be as creative as possible to reach that goal. A variety of approaches could be used, some of which might be based on the success achieved and lessons learned from each service’s initiation of a tobacco ban during basic training. Different groups of new accessions could be targeted over a timeline specified by each armed service. Military officers might be one of the easiest groups to initially target inasmuch as they are held as role models for the enlisted force and their tobacco use is already the lowest among military groups (see Chapter 2). Among new officer accessions, people attending the US military service academies would be the easiest to target initially. For example, the Air Force Academy could establish a date when entering freshmen would be informed that tobacco use would be



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