Military culture enables tobacco use

Military culture perpetuates the notion that using tobacco provides stress relief, a new study in the American Journal of Health Promotion finds. But other stress relievers, such as exercise or taking meditation breaks, could be more valuable and effective than smoking breaks and avoid the health risks of tobacco.

"You hear from military people and even sometimes from public health professionals that soldiers need tobacco for stress relief because of their difficult circumstances," said Elizabeth Smith, Ph.D., the study's lead author and an adjunct professor in the Department of Social and Behavioral Sciences at the University of California, San Francisco.

Yet Smith noted that studies of tobacco use for stress relief among soldiers have produced no evidence supporting the theory that tobacco use relieves stress. "Users indicate that they have more stress than nonusers and than those who have quit," Smith noted. Still, tobacco use is an accepted part of daily life in the military and users are provided with frequent breaks to smoke or use chewing tobacco.

Tobacco use threatens both the long-term health of enlisted personnel and their immediate readiness to perform, the authors observed, adding that tobacco's only real stress-relief component applies to relieving tension related to nicotine addiction.

Military tobacco use levels are high: 24 percent of military personnel are current smokers and 20 percent use smokeless tobacco. The Institute of Medicine has recommended a ban on military tobacco use. Smith noted that outgoing Secretary of Defense Chuck Hagel ordered a review of military tobacco control policies, which is ongoing.

Smith's study used focus group and interview data from two prior projects, including focus groups with 189 enlisted people. Group topics included how the military encouraged or discouraged tobacco use and the availability of cessation help. An additional 52 interviews with participants such as military tobacco control managers and military health policy leaders addressed barriers to military tobacco control and industry influence on military tobacco issues, among other areas.

Bret A. Moore, Psy.D., acknowledged that reducing tobacco use in any group is "laudable" and said studying ways to curb unhealthy behaviors in the military is important. But Moore, a psychologist who has served in the military and authored "Taking Control of Anxiety: Getting the Best of Worry, Stress and Fear," questioned the researchers' contention that the military perpetuates "myths" that support tobacco use. "It's important not to negate the subjective views of potentially hundreds of thousands of military personnel who believe that tobacco reduces their stress," he said.