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MILITARY TOBACCO CONTROL: LEADERSHIP’S CALL TO ACT

MILITARY TOBACCO CONTROL: LEADERSHIP’S CALL TO ACT . Sandhia Rajan December 05, 2011 Capstone Advisor: Anna Durbin Ph .D. Johns Hopkins Bloomberg School of Public Health. My Report.

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MILITARY TOBACCO CONTROL: LEADERSHIP’S CALL TO ACT

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  1. MILITARY TOBACCO CONTROL: LEADERSHIP’S CALL TO ACT Sandhia Rajan December 05, 2011 Capstone Advisor: Anna Durbin Ph.D. Johns Hopkins Bloomberg School of Public Health

  2. My Report Incorporate findings in the recent literature that examine the tobacco control environment in the U.S military in order to develop a problem-solving paradigm. • Defining the problem • Measuring the magnitude of the problem • Developing a conceptual framework for the key determinants of the problem • Identifying and developing intervention and prevention strategies • Setting priorities among strategies and recommending policies • Implementing programs and evaluating them • Communication Strategy GuyerB (1998). Problem solving in public health (pp. 15-26). In: H Armenian and S Shapiro, (Eds) Epidemiology and Health Services Research. New York: Oxford University Press.

  3. These troops are essentially putting their lives at risk twice: once in service to their country and once in service to tobacco. Tobacco is a long-term engagement — it kills slowly and insidiously. — Stuart Bondurant, chair of the Committee on Smoking Cessation in Military and Veteran Populations

  4. Public Health Problem 2008 DoD Survey of Health Related Behaviors: • 31% of military members smoke • 14% of military members use smokeless tobacco • 25% have smoked a cigar in the past year U.S. military population largely fit the mold of the tobacco industries prime target: the young and high school-educated Bray R.M. (2008). Department of Defense survey of health related behaviors among military personnel. Retrieved from http://www.tricare.mil/tma/studiesEval.aspx

  5. The Paradox In all military services: • 16% of smokers quit smoking • 48% of smokers attempted to quit smoking in the past year • Two out of three past-year smokers made an attempt to quit smoking in the past year Why, despite the desire to be tobacco free, does the active duty military population struggle with such high rates of use? Bray R.M. (2008). Department of Defense survey of health related behaviors among military personnel. Retrieved from http://www.tricare.mil/tma/studiesEval.aspx

  6. Magnitude • Tobacco use costs DoD an estimated $1.6 billion a year • Smoking behavior is the best predictor of military training failure leading to an excess training cost of $130 million • Weaker force decreases the security of the United States Klesges, R.C., Haddock, C.K., Chang, C.F., Talcott, G.W., & Lando, H.A. (2001). The association of smoking and the cost of military training. Tobacco Control, 10, 43-47. TRICARE. (2008). Department of defense anti-tobacco campaign invades military markets. TRICARE News Release. Retrieved from http://www.tricare.mil/pressroom/news.aspx?fid=379

  7. Conceptual Framework

  8. Intervention and Prevention Strategies • Limiting access to tobacco products • Increasing the price of tobacco products in military facilities • Comprehensive tobacco use restrictions in DoDfacilities • Transparent evidence-based comprehensive tobacco cessation services Institute of Medicine (U.S.)., Bondurant, S., & Wedge, R. (2009). Combating tobacco use in military and veteran populations. Washington, D.C: National Academies Press.

  9. Setting Priorities

  10. Recommendation Increase price of tobacco products sold in military facilities to equal local commercial price • Significant impact on both initiation and cessation of tobacco users • Minimal impact on DoD resources • Historically, a similar strategy was implemented successfully Ross, H., & Chaloupka, F.H. (2002). Economics of tobacco control. International Tobacco Evidence Network. Ranson, K.M., Prabhar J., Chaloapka F.J., & Nguyen S.N. (2002). Global and regional estimates of the effectiveness and cost-effectiveness of price increases and other tobacco control policies. Nicotine & Tobacco Research, 4, 311-319.

  11. Implementation and Evaluation

  12. Communication Strategy Leadership driven: • Identify an implementation strategy • Identify the target audience which includes military installations, tobacco retailers, and consumers • Involve the commissaries and base exchanges in the implementation strategy • Warn consumers of increase in prices • Promote cessation services • Incentivize healthier habits through other forms of military benefits

  13. Conclusion Immediate action: Price increase for tobacco products may be a necessary forced catalyst to motivate a change in behavior. Next steps: • Limit point of sales • Move toward a complete ban of tobacco sales on military installations • DoD authority • Reform military image

  14. Questions?

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