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DHA brings big guns to bear in the war against tobacco use

Activities like this barbecue for the Great American Smokeout at the 22 Area Single Marine Program recreational center on Camp Pendleton, Calif., are among many efforts to educate service members and beneficiaries about dangers related to tobacco and nicotine use. (U.S. Marine Corps photo by Cpl. Anabel Abreu-Rodriguez) Activities like this barbecue for the Great American Smokeout at the 22 Area Single Marine Program recreational center on Camp Pendleton, Calif., are among many efforts to educate service members and beneficiaries about dangers related to tobacco and nicotine use. (U.S. Marine Corps photo by Cpl. Anabel Abreu-Rodriguez)

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With all the valid reasons not to use tobacco, too many people still do. While national statistics show that fewer people are smoking cigarettes, consuming smokeless products, and vaping, they also show that one in every five Americans partake in tobacco in some form.

U.S. Public Health Service Capt. Kimberly Elenberg, a key point person for the Pentagon’s tobacco use-cessation efforts, says the number of smokers in uniform is going down, as it is for the overall population. Still, she says, the many studies of tobacco consumption throughout the Defense Department show that it continues among service members at a higher rate than their civilian counterparts.

As the Great American Smokeout gets underway Thursday, Nov. 21, Elenberg and her colleagues are making a special effort to lessen the use of a product known to kill. No one, she believes, should have to endure tobacco-related heart disease and cancer – not to mention the price of the products themselves or the financial burden associated with costs in work hours and the adverse effects on performance.

Elenberg, her co-workers at the Defense Health Agency Combat Support Agency, and the military medical community want everyone in uniform who use tobacco, as well as military retirees and family members, to get the upper hand on quitting.

“Our prevalence rates for smoking have been going down year after year, which is fantastic,” said Elenberg, who holds a doctorate in nursing practice. “But we [in the military] are much higher for tobacco use, and e-cigarette use is much higher than the rest of the nation too.”

This year, Elenberg said, the DHA is continuing to offer support online and through social media. “We’ve totally refreshed the YouCanQuit2 social media campaign,” she said. “We moved it from dot-mil to the dot-org environment in collaboration with the Department of Veterans Affairs because we know a lot more people would feel more comfortable doing something [other than in] a dot-mil environment.” As a result, the YouCanQuit2 website has a new address that she hopes might be less intimidating: www.ycq2.org.

There, tobacco users in the military community can “understand the options they have for quitting,” Elenberg said, adding they can set goals for stopping and get a financial perspective on use.

“We have 24/7 quit lines, because service members work different shifts,” Elenberg said. “We want to accommodate [those in] different time zones around the world.”

The program also has a significant presence on Facebook, Twitter, and Instagram. The intent, Elenberg said, is to be “Edgy and honest. We want to make sure our service members are informed.”

Elenberg is interested in building stronger bonds with other federal agencies beyond VA. “The department works very closely with the FDA and CDC,” Elenberg said. “When new medical options evolve, we work hand in hand to determine if it’s something that might benefit our population.”

She also seeks out comparable state and local anti-smoking programs to ensure that the military community is aware of as many avenues for cessation as possible. Through no ill will, institutional or otherwise, many of these civilian programs are currently not accessible to service members, retirees, and their families.

Even though statistics on nationwide cigarette smoking come from many sources and are not always consistent, Elenberg believes that DHA’s conclusion based upon an aggregate of those sources shows that overall nationwide use – including in the military – is dropping.

The most recent available data, published in 2017, was based on 2014 costs. Those figures showed that the Defense Department spends nearly $1.6 billion a year on medical and nonmedical costs related to tobacco. This includes tobacco-related medical problems, as well as nonmedical costs for active duty.

Elenberg is encouraged by both the data at hand and the possibility for improvement. According to the 2014 study, if the smoking prevalence among prime beneficiaries could reach the goal of 12 percent through additional measures, the lifetime savings could mount to $1.97 billion.

YouCanQuit2 and the overall anti-tobacco effort will continue beyond the Great American Smokeout, Elenberg said. A partnership between DHA and the Department of Defense Education Activity (DODeA), focuses on educating the children of service members, with the hopes of preventing them from ever starting to use tobacco.

“We want to address and lower the barriers that may exist,” Elenberg said.

The effort also targets the social activities associated with tobacco use, such as alcohol consumption.

“We’ve decided that we want to make sure we have alternatives for people who want to quit,” Elenberg said, “options for dealing with cravings and activities in which you can engage yourself so you’re not feeling you need to use tobacco.”

TRICARE provides a variety of benefits and services dedicated to helping service members and beneficiaries quit tobacco use. These include counseling services through authorized providers in the U.S. and prescriptions for tobacco-cessation products either through home delivery or at military pharmacies. Services and programs also are available to families stationed abroad who are enrolled in TRICARE PrimeA managed care option available in Prime Service Areas in the United States; you have an assigned primary care manager who provides most of your care.TRICARE Prime Overseas. For more information, visit TRICARE on the web.

Medicare-eligible retirees can find smoking-cessation help through their Medicare provider. Coverage is available only to retirees who are covered under Medicare Part B.

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Smokeless Tobacco Use in the US Military

Presentation
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Smokeless Tobacco Use in the US Military briefing to the Defense Health Board, Nov. 1, 2016.

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