Rise in smoking harms Soldiers, readiness
June 14, 2012
FORT SILL, Okla.-- The use of tobacco products remains a major health issue in civilian and military populations. There are almost 450,000 premature deaths each year that are smoking-related, according to the Centers for Disease Control and Prevention in Atlanta. And, while there has been a slight decline in tobacco use over the past few years in the civilian population, the numbers for military personnel have gone the other way.
"Approximately 52 percent of all E-1 through E-4 enlisted Soldiers Armywide use tobacco products, and the majority of that is smoking," said registered nurse Kelda Hodges, Reynolds Army Community Hospital Tobacco Cessation and Health Promotion director.
"Tobacco use by Soldiers is a major issue with regard to their being fit to fight. For one thing, smoking causes decreased night vision. There is also a misconception that smoking actually helps them perform on PT tests. They will come in and tell me that they are afraid to quit smoking close to a required PT test because they say their run times will get worse. That is just not the case," she added.
According to Army Regulation 600-63, the use of all tobacco products, including cigarettes and smokeless products, harms a Soldier's readiness by impairing physical fitness and increasing the possibility of illness.
Research shows that military personnel who smoke score lower on fitness tests, as much as 35 points lower than their non-smoking counterparts. Smokers also did fewer push-ups and ran slower than even former smokers or those who never smoked. Smoking reduces lung capacity and lowers oxygen levels in the blood, which causes muscles to tire more quickly.
"Tobacco use is also a huge financial issue for lower-level enlistees, E-1 through E-4. If a Soldier smokes a pack a day and buys cigarettes here at Fort Sill every day, they are spending over $2,000 a year," Hodges said.
Hodges went on to say if the Soldier has a spouse or significant-other, that about 30 percent of those spouses will smoke as much as the Soldier does.
"Both of them together are spending over $4,000 a year on tobacco products," Hodges said. "The financial burden is huge on these Soldiers, especially if they have families. That amount, $2,000 is more than some of them take home in a month."
Soldiers who are in Initial Entry Training or Advanced Individual Training programs are not allowed to use tobacco products at all, and sales of tobacco products to Soldiers during these training periods are prohibited. As per the Fort Sill Blue Book, Soldiers are restricted as to where they can smoke. They are also not authorized to smoke and walk at the same time while in uniform.
Tobacco use reduces military readiness because nicotine in cigarettes and smokeless tobacco is addictive, and causes users to regularly feed their habit or they will go through withdrawal. This withdrawal causes Soldiers to become irritable, restless, anxious, depressed and angry. There is also loss of concentration and slower reaction times, which can compromise a Soldier's ability to complete the mission in critical times.
"Smoking is part of the military camaraderie and that makes it harder to quit. A lot of people think that Soldiers smoke because they are so stressed, but ironically when I talk to them in my cessation classes, most of them tell me they smoke because they are bored," Hodges said. "I haven't had one of them say that they smoke because of stress. It's because they are bored."
Hodges went on to explain nicotine use causes the body to release dopamine, a chemical in the brain that controls feelings of motivation and reward.
"Dopamine makes us feel good. It gives us a sense of calmness and satisfaction. But as the dopamine levels increase, the user needs to feed the brain more nicotine," she said. "That is necessary so that the brain maintains the same response, otherwise feelings of depression and anxiety occur, which is the addiction.
"Over time, too much dopamine will cause the tobacco user to have anxiety, insomnia and restlessness, and continued use will not calm these feelings. The downward spiral of addiction increases as the user tries to regain the calm feeling they once felt with tobacco," Hodges added.
She tells Soldiers when they are in a program trying to quit, to not sit on their hands while their buddies go out to smoke because they won't be successful. When they feel that urge of withdrawal coming on, they should get up and do something.
"I tell them to do 30 seconds of very quick, very intense activity, like 30 seconds of push-ups. Or 30 seconds of sprints, something that is very vigorous and will release enough dopamine and adrenaline to get them through the next hour," Hodges said.
"Soldiers have to realize that they can be in control of those feelings, and take back the reins of releasing their own dopamine when they think they need it and not depending on the tobacco," she added.
Hodges said the tobacco cessation program at Fort Sill offers counseling and the use of bupropion, also known as Zyban, or nicotine replacement therapy patches. The program also uses behavior modification, to replace bad behavior with good behavior by having a support group, buddy system or someone to hold the person accountable for their performance during the modification process.
"When you are trying to get someone to stop using tobacco you can't hit them with 'You need to change your diet, you need to start exercising so you can lose weight, etc.' You can't put a lot of things on them at once. You have to really work all of that in there without the person knowing that that is what you are doing," she said. "These guys need success and I can't set them up for failure."
Soldiers at Fort Sill who want to quit using tobacco products can call the Tobacco Cessation program at RACH at 442-0684/2061. There are also online resources for quitting at www.smokefree.gov, and www.militaryonesource.com, and a toll-free hotline at 800-QUIT NOW.