Before he retired from the Navy Dental Corps, Dr. Larry Williams used to help sailors quit using tobacco. One reason he says they start smoking, chewing or dipping is peer pressure.
“The imagery, the socialization, the context of being able to be with people your own age and talk about things” is key, he says. But tobacco use trumps rank, and users can end up crowded together, forced to forget protocol for the tiniest of whiles.
“It’s the one opportunity you have,” Williams says, “in the smoke deck, or the smoking area, that you can go as an E3 and stand next to an E6 and talk to them and learn things that other people might not be able to pick up.”
Members of the military use tobacco more than civilians. Depending on the division and age groups you look within, Williams says, usage rates can be as high as 32 percent. In the military, tobacco can be hard to avoid. Take one of Williams’ colleagues, a sailor working in a medical clinic, who alerted Williams that he was about to start smoking.
“I looked over at him and said, ‘why?’ And he said, ‘Well, everybody else in the office smokes, and when the senior chief goes outside to smoke, they all go with him and they leave me behind to take care of all the work in the office.’”
Williams was raised on a tobacco farm. It was the experience of seeing relatives die from tobacco-related illnesses, like emphysema, lung disease and cancer, that steered him to his eventual career, he says. He’s now a consultant to the National Development and Research Institute looking at the effectiveness of tobacco policy and cessation programs in the military.
Tobacco use, notes Williams, harms the health and readiness of troops and costs taxpayers billions.
“If you’re a smoker, your hospital stays are 20 percent longer,” he says. “You have a double risk of postoperative infection from any surgery that you have.”
The defense department spends $1.6 billion a year on tobacco-related expenses, like treating chronic obstructive pulmonary disease.
A discounted risk
Despite the numbers, members of the military get discounts on all kinds of products at military base stores, including tobacco—which the military sells a lot of. In the last year numbers were available, the Army and Air Force sold just under $400 million worth.
A new provision in next year’s spending bill for the Defense Department would eliminate that discount.
Williams says he also wants the discount ended. However, he says, doing so could be difficult.
“The profits from tobacco sales on the base—those are used by MWR—morale, welfare and recreation. It helps pay for the day care centers. It helps pay for the gymnasiums, for the clubs,” he says. So “any sale of tobacco is sort of a benefit. And that’s one of the things we need to remove—is any association between profits from items that cause health issues should be removed and that money come from another source.”
The military has been struggling for years with how to address tobacco, but it keeps getting caught up in politics, says Erika Sward, assistant vice president for national advocacy at the American Lung Association. Sward calls the problem the “iron triangle.”
“When the military has tried to do something,” she says, “Congress has stopped them because of tobacco industry’s lobby and pressure.”
“There’s a law that prohibits the Veteran’s Administration from making its hospitals tobacco-free,” she says. “There’s a constant back-and-forth between the tobacco industry and Capitol Hill.”
Sen. Richard Durbin, chairman of the Senate Defense Appropriations Subcommittee, included a provision in next year’s Defense Department spending bill that would end the military’s discount on tobacco products. He notes that, according to DOD policy, tobacco may only be discounted 5 percent.
But via an emailed statement he said, “In practice, these discounts are much greater. A study comparing cigarette prices at 145 military retail stores and their nearest Walmart found that the average discount on Marlboro Red brand cigarettes was 25.4 percent.”
Will removing discounts change habits?
When tobacco is cheap, people buy more.
“We know that one of the greatest ways to reduce tobacco use across the board,” says Sward, “is to increase the price. But when the military is subsidizing the cost of tobacco use, or undercutting local prices, as a result it means that cheaper tobacco products are more available and more people are likely to use them among military personnel.”
An amendment to the spending bill, introduced by California Rep. Duncan Hunter, would prevent restrictions on sales of any products currently in stock at base stores, including tobacco.
Hunter declined an interview request, as did all but a few of the 53 of the 62-member Armed Services Committee who voted in favor of the amendment, effectively opting to continue the discount on tobacco.
Southern Mississippi Rep. Steven Palazzo, who served for eight years in the Marine Corps Reserves, and a member of the Armed Services Committee, cast his vote with the majority.
“What’s next? Are they going to not allow you to eat a cheeseburger?” he questioned. “Hey, caffeine is bad for you so no more coffee? No more Krispy Kreme doughnuts? You’re talking about a lance corporal in the United States Marine Corp that just got through two weeks of hellacious fighting—seeing his buddies basically blown to pieces in front of him in Fallujah and he wants to come back to the fort operating base and have a cigarette?”
Palazzo says he knows ending the discount isn’t the same as removing tobacco products from base stores altogether, but he says doing away with the discount would represent “a slippery slope.”
Besides, he says, why single out one product? Especially given the kind of work that soldiers do.
“The availability of tobacco products in a combat zone is not the threat. The threat is the bullets coming from the enemy,” he says. “But you know, we’re not going to ban war, so why would we ban tobacco products for our military?”
A question Senate isn’t currently facing. However, the issue of the military’s discount on tobacco products is expected to come before legislators this fall.