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Combating Tobacco Use in Military and Veteran Populations (2009)
Board on Population Health and Public Health Practice (BPH)

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. "2 SCOPE OF THE PROBLEM." Combating Tobacco Use in Military and Veteran Populations. Washington, DC: The National Academies Press, 2009.

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Combating Tobacco Use in Military and Veteran Populations

greater likelihood of not completing the training course (p = 0.023) (Snoddy and Henderson, 1994).

Klesges et al. (2001) reported that tobacco use was associated with early discharge from the Air Force. In a study of 29,044 Air Force recruits in 1995–1996 who were followed for 12 months, 19.4% of smokers and 11.8% of nonsmokers were prematurely discharged (RR, 1.795; 95% CI, 1.676–1.923). The premature discharges resulted in $18 million in excess training costs for the Air Force and over $130 million for all four services (Klesges et al., 2001). Conway et al. (2007) found that women who were daily smokers before entering the Navy had poorer job performance than nonsmokers as demonstrated by early attrition before serving a full-term enlistment, were more likely to have a less-than-honorable discharge, had more demotions and desertions, achieved a lower paygrade, and were less likely to re-enlist. Early discharge from the military has also been associated with smoking in other countries, such as Sweden (Larsson et al., 2009).

Tobacco Sales on Military Installations

DoD, through its exchanges and commissaries, provides active-duty and retired armed service members and their families with access to a wide array of consumer goods at reduced prices relative to the private market. Military exchanges are the primary venues for the sale of nonfood merchandise, including tobacco products. According to DoD Instruction 1330.09 (December 7, 2007), exchanges have the dual mission of providing merchandise and services and of generating earnings that help to fund military MWR programs, including child care for dependents of military personnel. Exchanges are supported solely by nonappropriated funds, which are derived from the sale of goods and services to DoD military and civilian personnel and their family members. The nonappropriated funds are used to support MWR programs.2

As authorized by Congress (10 United States Code [USC] Section 2486 [a]), military commissaries are equivalent to commercial grocery stores and sell similar merchandise. Unlike military exchanges, commissaries are supported by congressionally appropriated funds and sell goods at actual product cost to the military plus a 5% surcharge (10 USC Section 2484 [d][e]). Commissaries have the authority to sell

2

According to written testimony to the House Armed Services Committee by Alphonso Maldon, Jr., assistant secretary of defense (force management policy), on March 15, 2000, exchanges designate about 70% of their profits to MWR programs.

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