Health Hazards

Gastrointestinal disease

Peptic ulcer

Esophageal reflux

Reproductive disturbances

Reduced fertility

Premature birth

Low birth weight

Spontaneous abortion

Abruptio placentae

Premature rupture of membranes

Increased perinatal mortality

Oral disease (smokeless tobacco)

Oral cancer



Gingival recession

Tooth staining


Non-insulin-dependent diabetes mellitus

Impaired wound healing



Amblyopia (loss of vision)

Age-related macular degeneration

Premature skin wrinkling

Aggravation of hypothyroidism

Altered drug metabolism or effects

SOURCE: Adapted from US Surgeon General (2004).

Short-Term Effects of Tobacco Use

In addition to the widely acknowledged long-term health consequences of tobacco use such as cancer and cardiovascular disease, tobacco use also adversely affects performance and health on a much shorter time scale. Being tobacco-free is an essential component of physical fitness and provides myriad advantages to military personnel in terms of readiness and performance. In the sections below, the committee considers the performance and short-term health consequences of tobacco use that are of most importance for active-duty military personnel. Box 2-1 at the end of the section summarizes the effects of tobacco use on military readiness and short-term health.

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