Adverse Effects of Tobacco Use in Deployed Military Units
LT Merle PARMAK MSc
Applied Research Centre, Estonian National Defence College
Riia 12, 51013 Tartu
Phone +372 51 21 490 / Fax +372 717 6111
CDR RNLN Marten MEIJER PhD
Associate Professor Netherlands Defence Academy
De la Reijweg 120 4818 BB Breda
PO Box 90002, 4800 PA Breda
Phone ++ 31-76 5273204 / Fax ++ 31-76 5273255
ALTHOUGH RESEARCH REVEALS THAT SMOKING PREVALENCE HAS IN GENERAL STABILIZED OR IS EVEN DECREASING AMONG MILITARY PERSONNEL, THIS TREND DOES NOT ULTIMATELY APPLY. BEING YOUNG, BEING DEPLOYED, OR BEING A MEMBER OF ARMY PERSONNEL, FOR INSTANCE, IS PROVEN TO INCREASE THE RISK OF BEING OR BEGINNING TO BE A TOBACCO USER. THERE ARE NOT IMMEDIATE OBSERVABLE LINKS BETWEEN TOBACCO HABITS AND THE SERIOUS HEALTH-RELATED CONSEQUENCES FOUND DURING THE SERVICE PERIOD BECAUSE OF THE LONG TIME LAG BETWEEN TOBACCO USE AND ITS CONSEQUENCES. ALSO THE IMPACT OF SMOKING ON MILITARY PERFORMANCE CAN BE DEFINED RATHER MORE INDIRECTLY THAN DIRECTLY. HOWEVER, FINDINGS IN THE ESTONIAN MILITARY SAMPLE (N=135) INDICATE THAT AN INCREASE IN SMOKING BEHAVIOUR WHILE ON DEPLOYMENT NOT ONLY CORRESPONDS WITH POORER PSYCHOLOGICAL WELLBEING AND GENERAL HEALTH, BUT ALSO WITH BEING FORCED TO STAY AWAY FROM DUTY BECAUSE OF PHYSICAL ACHES. THESE RESULTS CAN BE TAKEN AS INDICATORS THAT SMOKING BEHAVIOUR DECREASES FITNESS FOR MILITARY OPERATIONS AND SHOULD BE TARGETED BY PERFORMANCE ENHANCEMENT ACTIVITIES. THE ROLE OF THE MILITARY CULTURE OF SMOKING BEHAVIOUR AND THE ARGUMENTS FOR AN EFFECTIVE STRATEGY FOR TOBACCO USE CESSATION AMONG MILITARY PERSONNEL ARE DISCUSSED.
1.0TRENDS IN TOBACCO USE
CONSIDERING THE DIRECT AND INDIRECT COSTS RELATED TO CONSEQUENCES OF TOBACCO HABITS, HIGH IMPORTANCE HAS BEEN ATTRIBUTED TO THIS BEHAVIOUR IN HEALTH POLICIES. TOBACCO USE IS KNOWN AS THE SINGLE LARGEST CAUSE OF PREVENTABLE DEATH IN THE WORLD TODAY, KILLING A THIRD TO A HALF OF ALL USERS. PROJECTING INTO THE FUTURE, THE TOTAL TOBACCO-ATTRIBUTABLE DEATHS WILL ACCOUNT FOR ALMOST 10% OF ALL DEATHS WORLDWIDE IN 2030.[i] IN THE WHO EUROPEAN REGION, SMOKING IS BLAMED FOR ABOUT 18.6 MILLION YEARS OF LIFE LOST.[ii]
The financial costs caused by tobacco-related illnesses and medical care are remarkable. The direct and indirect costs of smoking in the EU, for instance, were estimated to range from 1.04% to 1.39% of the EU Gross Domestic Product, exceeding even 3% of it in some new member countries.[iii]
Some pessimistic prognoses show that the worldwide number of smokers continues to increase[iv] and that the deaths caused by tobacco will double over the next few decades[v]. However, the trends of tobacco- related habits in the Western world are constantly decreasing. According to the latest health surveys in the US and in Europe, smoking prevalence among men and women has in general stabilized or is even decreasing. For example, in the US, the past month use of tobacco products was 29.4 % in 2005, while it was 30.4% in 2002[vi]; in the WHO European Region, smoking prevalence was estimated around 28.6% in 2005 but 28.8% in 2002. Falling death rates due to tobacco- related illnesses imply that trends in smoking prevalence have been curbed at least since the early eighties.[vii]
Findings from Western military surveys show similar trends and indicate overall declines in smoking as well. For example, in the total military population, the prevalence of any smoking in the US declined from 51.0% in 1980 to 32.2% in 2005.[viii] In the Canadian Forces, everyday smoking has decreased from 24% in 2000 to 20% in 2004; the latter figure is declared to be even lower than in the civil population.[ix] However, low smoking rates in the armed forces are not the case in every country, and cannot be generalized to all tobacco products or age groups.9 In Estonia, for instance, we can observe the...