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1 INTRODUCTION
Pages 19-30

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From page 19...
... . It adversely affects military readiness, harms the health and welfare of military retirees and other veterans, and costs our nation millions of dollars in lost productivity and increased health care.
From page 20...
... The populations considered in this report include military retirees and, to a lesser extent, spouses and dependents; the veteran populations considered are primarily men and women eligible to receive health care through the Veterans Health Administration. This unique combination of demographic factors may require some modification of general-population tobacco-control programs to address the specific needs of military and veteran populations.
From page 21...
... Unlike most retailers, the military has a special interest in its patrons, whose fitness is necessary to the military's mission." Many military tobacco-users will eventually enter the VA health system or the DoD TRICARE health-care system. Those two health-care systems bear much of the burden of care; thus, each has a vested interest in assisting active-duty and retired military personnel and veterans to stop using tobacco.
From page 22...
... In response to the agencies' request, IOM convened the Committee on Smoking Cessation in Military and Veteran Populations, which wrote this report. In reviewing the original statement of task, the committee felt it appropriate to modify the language slightly from "smoking" to "tobacco" so that all tobacco products, particularly smokeless tobacco, would be included; the statement of task above reflects the committee's modifications.
From page 23...
... THE COMMITTEE'S APPROACH TO ITS CHARGE The committee had several goals: to review current efforts by DoD and VA to reduce tobacco use and dependence; to make recommendations for a comprehensive approach to control of tobacco use that would lead to eliminating tobacco use and dependence in all military personnel and veterans in the VA or DoD system; to help DoD become tobacco-free by preventing initiation, thus improving the health and readiness of military personnel and eventually improving veteran health; to help military personnel who do use tobacco to quit and remain abstinent; and to help veterans in the VA health-care system to avoid or quit using tobacco. The committee also hoped to provide additional tobacco-cessation guidance to military personnel and veterans who have such conditions as posttraumatic stress disorder (PTSD)
From page 24...
... The committee found the presentations from the representatives of each of the armed services on current practices regarding tobacco control to be very helpful, but the committee was aware that the representatives did not provide a comprehensive assessment of what tobacco-control activities occur throughout their service and on individual military installations. The VA has conducted surveys and held forums that provide more helpful information on the tobacco-control activities at some VA health facilities and these resources are cited throughout this report.
From page 25...
... In addition to treatment, there is a need for system change at the local level to enact program changes that will increase the likelihood of health providers helping users to quit. Local program change implies culture change and requires strong leadership; clear patient, staff, and environmental goals; strategic plans that include specific objectives and tactics; and policies to promote the sustainability of the change efforts.
From page 26...
... Neither department has taxing capability, both must answer to Congress for any substantial changes in operations, military and veteran populations are not representative of the general US population, and their missions differ from those of state or local governments. Furthermore, DoD and especially VA have populations with a high prevalence of comorbid health problems such as psychiatric disorders (particularly PTSD)
From page 27...
... This chapter describes the key components of comprehensive programs developed by other organizations, such as state governments, that have proved to be successful in reducing tobacco consumption in other populations: communication interventions, such as counteradvertising and public-education campaigns; tobacco-use restrictions in the workplace, educational settings, and outdoor spaces; the tobacco retail environment; tobacco-cessation interventions, such as counseling and medication; delivery mechanisms for the interventions, such as quitlines, clinical settings, and computer-based programs; tobacco-cessation approaches for special populations, such as those with mental-health disorders and comorbid medical conditions; relapseprevention approaches; and surveillance and evaluation. In Chapter 5, the committee looks at DoD through the lens of a comprehensive tobaccocontrol program and examines what policies, programs, and services the department already has in place that meet the requirements with respect to each of the key components.
From page 28...
... 2007. Death at a discount: How the tobacco industry thwarted tobacco control policies in US military commissaries.
From page 29...
... 2004. Building Blocks for Tobacco Control: A Handbook.


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