SCHOFIELD BARRACKS, Hawaii - Tobacco use in the Army is a high-profile issue and has a direct impact upon a Soldier's ability to accomplish the mission.
According to the U.S. Army Public Health Command (Provisional) website, the short-term impacts of tobacco use on readiness include increased numbers of sick call visits and increased incidents of cold weather and training injuries.
In addition, well-known long-term health hazards include reduced lung capacity, reduced fine-motor coordination, slower wound healing and decreased stamina.
"Tobacco use is the single most preventable cause of death in the U.S," said Michael Kellar, chief, Behavioral Medicine Service, Department of Psychology, Tripler Army Medical Center, and director of TAMC's Tobacco Cessation Program, which provides comprehensive outpatient treatment for those wishing to stop smoking or using smokeless tobacco.
"We meet as a group, weekly, for an hour," Kellar said. "These sessions discuss the physical, social and habit aspects of tobacco cessation.
"In addition to the lifestyle and behavioral strategies," he continued, "we integrate either nicotine replacement or oral medication into our program, to help with the physical discomfort associated with stopping smoking or dipping."
After a preliminary health screening and orientation, the group meets for 10 weeks. Then, after completing the program, patients can request biweekly follow-on care for an additional 12 weeks.
The program has psychologists who specialize in behavioral medicine and health psychology, primary care physicians, psychology interns and fellows, and paraprofessionals who assist the team.
TAMC offers classes on Tuesdays, Wednesdays and Thursdays. The Schofield Barracks Acute Care Clinic holds classes Tuesdays, and can export its program to other installations.
"(More than) 400,000 Americans die of tobacco-related causes each year, and it is estimated that (more than) $165 billion is spent on associated health-related costs," Kellar said. "Unfortunately, tobacco use rates are higher in the military than they are among civilians. The Department of Defense spends approximately $130 million in training for those who will replace service members prematurely discharged for tobacco-related health conditions."
DoD has been attacking smoking for several decades, Kellar said, adding that as far back as 1995, DoD has spent $584 million in related health care costs and $346 million in lost productivity for those who used tobacco.
"In 1975, cigarettes were no longer included in K-rations and C-rations," he said. "In 1984, smoking was banned in basic training. Smoking was banned in certain DoD workspaces in 1994. Then, in 2001, DoD regulated tobacco prices to be within 5 percent of the local economy."
Research shows that 50 percent of those who stopped smoking before joining the military, resumed after entering service. Kellar added that deployments are often associated with starting smoking or relapsing for those who have previously quit. This association is even stronger for those who have been deployed multiple times and been exposed to combat.
These facts present some readiness challenges. For example, service members who use tobacco tend to have lower fitness levels, decreased night vision, slower healing capacity and greater risk for physical injury.
"A study, a few years ago, found that the more someone smoked, the higher their risk of dying from an injury," Kellar said. "In addition to the health consequences, at an average cost of $8.39 per pack in Hawaii, cigarette smoking is also very costly."
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