Thursday, April 19, 2018

Military smoking: Hold your fire, please

Congressional efforts to limit or even stop men and women in the military from smoking cigarettes or using other tobacco products could create a major morale problem for front-line troops.

The Joint Chiefs of Staff see it coming and hope to get out in front of it.

Last month, during a Senate Appropriations defense subcommittee hearing on the fiscal 2015 defense budget, the panel's chairman, Sen. Dick Durbin, D-Ill., questioned the discount prices for tobacco products sold within the Defense Department. "We spend $1.6 billion a year on medical care of service members from tobacco-related disease and loss of work," he said.

Gen. Martin Dempsey, chairman of the Joint Chiefs, responded, "We've asked a lot of our men and women in uniform ... All the things you're talking about are legal, and they are accessible, and anything that makes anything less convenient and more expensive for our men and women in uniform, given everything we're asking them to do, I've got concerns about."

Reducing smoking in the military has been a creeping campaign for 30 years, starting with congressional efforts in 1985 to raise commissary cigarette prices to equal those in civilian stores. Instead of raising prices, then-Defense Secretary Caspar Weinberger set up an "aggressive anti-smoking campaign" after a 1986 Pentagon study showed military smokers were less physically fit than non-smokers and tobacco-related health costs might top $200 million.

Other steps have followed. Defense Secretary Chuck Hagel says he has ordered a review of all tobacco sales as part of a study of all health programs. On March 14, a department memo titled "Reducing Tobacco Use in the Armed Forces and the Department of Defense" noted department policies have "made great progress in reducing tobacco use. Yet our work is far from over."

The memo, which went to the service secretaries and the military chiefs of staff, set as a goal "to dramatically reduce use of all tobacco by 2020."

As late as 1975, cigarettes were part of soldiers' rations. Since then, a new attitude has developed. In 1994, the Pentagon banned smoking in workplaces and set up designated smoking areas. A 1997 executive order went further, banning smoking in all government-owned, rented or leased interior spaces. The Defense Department fully implemented that policy in December 2002.

To some degree, the Navy has led the way by eliminating smoking breaks and setting up smoking areas in offices, surface ships and submarines in the 1990s. In 2010, it banned all smoking on submarines.

In 1985, all military smoking was at 47 percent. It's dropped to 30 percent. However, as the March 14 memo states, "An estimated 175,000 current active duty service members . . . will die from smoking unless we can help them quit."

Durbin pointed out that the rate of smoking among the military is 20 percent higher than the overall U.S. civilian rate. "One out of three members of the military who use tobacco today say they started after they enlisted," Durbin added.

In 2005, smoking rates for 18-to-25-year-old military men was high at 42 percent, although it varied by service, with the Army and Marines being highest, and the Air Force the lowest. In short, smoking is highest with those most likely to be involved in fighting on the ground.

Last March, when Stars and Stripes carried a story about Navy Secretary Ray Mabus considering a ban on all tobacco sales on ships and bases, the comments received previewed what could come if more actions are taken. "THIS IS OUT OF CONTROL!!!!," wrote one ex-Marine. "When I was sitting in a bunker in Vietnam at 0400, a cigarette gave me comfort and pleasure. OH!!!! It is not good to get lung cancer but a sucking chest wound is???"

Dempsey was more diplomatic: Because smoking is legal, taking more steps to halt it "is an issue for the broader Congress of the United States, not uniquely for the United States military."

Rep. Duncan Hunter, R-Calif., a Marine Reserve major with three combat tours in Iraq and Afghanistan, has already acted. He argued at one point: "We sleep in the dirt for this country. We get shot at for this country. But we can't have a cigarette if we want to for this country, because that's unhealthy."

He got the House to approve his prohibition of any new restrictions on legal products — including tobacco, sold on military bases, commissaries, post exchanges, and even ships — added to the fiscal 2015 Defense Authorization Bill.

Let's see what the Senate does.

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