Monday, July 13, 2009

Tobacco ban is premature

Well-intentioned Pentagon health experts are urging Defense Secretary Robert Gates to ban the use of tobacco by troops and end its sale on military property. It's an admirable goal, and achievable some day. But the proposal, or at least its announcement, is ill-timed, coming last week just days after the largest one-day death toll in months for U.S. troops in Afghanistan.

A plan to ban tobacco is something to announce during peacetime.

The Institute of Medicine study, requested by the Department of Veteran Affairs and the Pentagon, notes that one in three servicemembers use tobacco, compared with one in five adult Americans, USA Today reported. The study also found:

Tobacco use increased after wars in Iraq and Afghanistan began, and troops worn out by repeated deployments often rely on cigarettes as a "stress reliever."

The heaviest smokers are soldiers (37 percent) and Marines (36 percent), who have done most of the fighting in Iraq and Afghanistan.

Combat veterans are 50 percent more likely to use tobacco than troops who haven't seen combat.

The study suggested the Pentagon consider gradually phasing out the subsidized sale of tobacco products on U.S. military bases and that it implement a series of tough anti-smoking measures, starting with new recruits. Well, with new recruits who aren't being sent off to war, anyway.

Focusing on smoking while troops are dying in combat has a missing-the-forest-for-the-trees feel. Studies and proposals don't happen in a vacuum. Or maybe they do, and that's the problem.

The military has a much more troubling health crisis right now -- and that is a record suicide rate among servicemembers. Like the smokers, the majority of military members who commit suicide saw combat, and served repeated deployments. And most were deployed repeatedly because the military has struggled at the same time to attract qualified recruits. Definitely a circular nightmare, and one in which cigarettes are not the villain.

When facing combat, fear, post-traumatic stress disorder, depression, traumatic injury, stressful life events -- things military personnel and veterans can struggle with daily -- tobacco use isn't the problem. The military is working on suicide prevention programs, even as the trend continues upward, reported. More, urgent work is needed.

The study cites rising tobacco use and higher costs for the Pentagon and VA as reasons for the ban. And the rising tobacco use is tied to combat in Iraq and Afghanistan. Which is maybe why the study's mixed-message recommendation is to phase-in the ban over years, perhaps "up to 20."