title: Perspectives of US military commanders on tobacco use and tobacco control policy.
abstract: Tobacco use among members of the US military service is unacceptably high, resulting in substantial healthcare and personnel costs. Support of military command is critical to the success of tobacco control policies because line commanders are responsible for implementation and enforcement. This study is the first to examine US military line commanders' perspectives about current tobacco control policies and the impact of tobacco on readiness.
  
  
  
  We conducted key-informant interviews with 20 officers at the US Army's Command and General Staff College about military tobacco use and tobacco control policy.
  
  
  
  Participants identified the long-term impact of tobacco use on military members, but were unaware of proximal effects on health and readiness other than lost productivity due to smoke breaks. Officers also discussed nicotine addiction and the logistics of ensuring that an addicted population had access to tobacco. Regarding policy, most knew about regulations governing smoke-free areas and were open to stronger restrictions, but were unaware of current policies governing prevention, intervention and product sales.
  
  
  
  Findings suggest that strong policy that takes advantage of the hierarchical and disciplined nature of the military, supported by senior line and civilian leadership up to and including the secretaries of the services and the Secretary of Defense, will be critical to substantially diminishing tobacco use by military personnel.
authors.affiliation: NDRI: National Development and Research Institutes, Inc., Institute for Biobehavioral Health Research, Leawood, Kansas, USA.
authors.forename: Walker S C
authors.initials: WSC
authors.lastname: Poston
authors.affiliation: NDRI: National Development and Research Institutes, Inc., Institute for Biobehavioral Health Research, Leawood, Kansas, USA.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Haddock
authors.affiliation: NDRI: National Development and Research Institutes, Inc., Institute for Biobehavioral Health Research, Leawood, Kansas, USA.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Jahnke
authors.affiliation: NDRI: National Development and Research Institutes, Inc., Institute for Biobehavioral Health Research, Leawood, Kansas, USA.
authors.forename: Nattinee
authors.initials: N
authors.lastname: Jitnarin
authors.affiliation: Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Malone
authors.affiliation: Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Smith
mesh_terms: D005260:Female; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008889:Military Personnel; D061845:Smoke-Free Policy; D012907:Smoking / Q000453:epidemiology*; D000074606:Smoking Prevention; D014481:United States
keywords: Addiction; Priority/special populations; Public policy