in providing assistance to military and veteran populations. Demonstration projects could be funded to determine the use and effectiveness of national quitlines for both DoD and VA with counselors trained to deal with issues peculiar to military and veteran life.

Evidence has shown that having a partner who smokes makes it more difficult for a person to quit smoking. VA does not provide tobacco-cessation medications for partners of veterans who use tobacco, although many VA tobacco-cessation counseling programs allow partners to attend the sessions. VA might explore the costs and long-term benefits that might accrue if partners were provided with cost-free or discounted tobacco-cessation medications.

Finally, there is the issue of resources to pay for services and to address the committee’s recommendations. The committee acknowledges that the DoD morale, welfare, and recreation programs receives a substantial portion of its budget from the sales of tobacco. DoD should undertake a study of finding alternative funding streams. It should examine what effect raising the prices of tobacco products would have on consumption and revenue.

The committee concludes that although DoD and VA have demonstrated a continuing commitment to the health of military personnel and veterans, respectively, particularly with respect to tobacco-use cessation, much remains to be done. Given the effect of tobacco use on military readiness and on the health of military personnel, retirees, families, and veterans, the time has come for DoD and VA to assign high priority to tobacco control.

REFERENCES

Arvey, S. R., and R. E. Malone. 2008. Advance and retreat: Tobacco control policy in the US military. Military Medicine 173(10):985-991.

CDC (Centers for Disease Control and Prevention). 2008. Cigarette smoking among adults—United States, 2007. Morbidity and Mortality Weekly Report 57(45):1221-1226.

DoD (Department of Defense). 2006. 2005 Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel. Research Triangle Park, NC: RTI International.

DoD. 2008. Evaluation of Tobacco Use Cessation Programs in the Military Health System. Washington, DC: DoD Military Health System Clinical Quality Management.

Fiore, M. C., C. R. Jaen, T. B. Baker, et al. 2008. Clinical Practice Guideline: Treating Tobacco Use and Dependence: 2008 Update. Washington, DC: Department of Health and Human Services, Public Health Service.



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