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Combating Tobacco Use in Military and Veteran Populations
Legislative support is essential for a comprehensive tobacco-control program in DoD and VA.
Congress should do the following:
Repeal the Veterans Health Care Act of 1992 (Public Law 102-585, §526) to allow VA health-care facilities to become completely tobacco-free.
Expand the 2009 National Defense Authorization Act Section 713, “Smoking Cessation Program Under TRICARE,” to include smokeless-tobacco cessation treatment.
Direct DoD to sell tobacco products at prices at least equal to and preferably greater than local civilian retail prices.
DoD and VA research contributes to identifying effective tobacco-control programs, particularly for special populations, such as those with mental-health and substance-abuse problems.
DoD and VA should develop and fund a joint comprehensive research plan on tobacco control in military and veteran populations.
Much research has been done on tobacco control by public entities and by DoD and VA. For example, VA has supported considerable research on tobacco use in veterans who have mental-health disorders, on new tobacco-cessation medications, and on the role of health-care providers in delivering tobacco-cessation services. DoD has funded studies on the initiation of tobacco use by new recruits and on relapse of tobacco use after basic training. But the committee was struck by several gaps in knowledge that should be filled through research. There is a dearth of information in both organizations about the success of their tobacco-cessation programs, particularly long-term abstinence rates. Some of that information should be generated by the program evaluation necessary for efficient operation, which needs to be enhanced. Beyond operational data, there is a need for research on changing demographics, behavioral and cultural inducers, and improved or innovative program design. Without such information, it is difficult to assess what programs are working for military personnel, retirees, their families, and veterans. It is possible that some programs work better for