health in the middle 1990s. Similarly, the potential influence of military leadership on programs, plans, and policies is enormous. The committee believes that without the enthusiastic support of involved leaders, tobacco control will not have a high priority in either DoD or VA. Considering the staggering toll of tobacco use on military readiness, lost productivity, adverse health effects, exposure to secondhand smoke, cost of tobacco products, and health-care expenditures, DoD and VA should develop, implement, and evaluate outcomes of continuing broad and systematic tobacco-control programs as major components of their health-care systems. Preventing tobacco use and reducing the number of tobacco users will result in great benefits to both organizations and improve the quality of life of military personnel, veterans, and their families for years to come.


In Table 7-1, the committee lists its major findings and recommendations. Findings and recommendations that refer specifically to DoD and VA are in Chapters 5 and 6, respectively.

TABLE 7-1 The Committee’s Findings and Recommendations for the Department of Defense and the Department of Veterans Affairs



Tobacco use in the US military and veteran populations exceeds that in the general population.


Tobacco use

  • impairs military operational readiness;

  • is a cause of increased morbidity and mortality in active-duty military personnel, retirees, veterans, and family members;

  • results in increased health-care costs for tobacco users and their families; and DoD, VA, and the general public; and

  • creates a patient pipeline from


DoD and the armed services haveDoD to VA. stated goals of being tobacco-free but have not achieved these goals.

The goal of a tobacco-free military service may be achieved incrementally. DoD and the armed services can use

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