A qualitative analysis of the tobacco control climate in the U.S. military.
BACKGROUND
Rates of tobacco use in the U.S. military have traditionally been higher than in the general U.S. population. While the military has experienced decreases in tobacco use over the past two decades, recent surveys suggest a trend of increased use. Given the negative impact of tobacco on both the readiness and the long-term health of military members, it is important to understand what factors may be related to the increased use rates. It has been suggested that there is a culture that supports tobacco use in the military.


METHODS
We examined perceptions about the climate of tobacco control among military installation Tobacco Control Managers and Service Policy Leaders from all four branches of the military (n = 52) using semistructured interviews.


RESULTS
The primary strength of the military's tobacco control program, according to the participants, was mandating the provision of treatment services on every military installation. Any military member can receive both counseling and pharmacotherapy for tobacco. Opinions vary on the most promising new strategies for tobacco control. Many have pushed for a completely tobacco-free Department of Defense, including requiring troops to be tobacco-free and banning tobacco sales on military installations. However, a number of tobacco control experts within the military worry about unintended consequences of a complete ban.


CONCLUSIONS
While several benefits of the current tobacco control program were identified, opportunities for improvement were identified at both the installation and service level.
Jahnke
Sara A
SA
Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS 66214, USA. jahnke@ndri.org
Haddock
C Keith
CK
Poston
Walker S C
WS
Hoffman
Kevin M
KM
Hughey
Joseph
J
Lando
Harry A
HA
D000328:Adult; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008887:Military Medicine / Q000458:organization & administration*; D008889:Military Personnel / Q000706:statistics & numerical data*; D036301:Qualitative Research; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000628:therapy*; D014481:United States; D055815:Young Adult