Low birth weight
Premature rupture of membranes
Increased perinatal mortality
Oral disease (smokeless tobacco)
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).
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.