Q. Address Individual Conditions in Special Populations
Q-3. Military Recruits and Trainees
OBJECTIVE
Prevent relapse of basic trainees who quit using tobacco as a result of their participation in basic military training.
BACKGROUND
Effective in 1986, basic military training in the DoD prohibited all forms of tobacco use. This decision was based on many factors, including those dealing with health, safety, and readiness. After completing basic military training, varying in length from 6 to 12 weeks, military trainees attend a variety of advanced training programs where tobacco control policies are less restrictive.
RECOMMENDATIONS
- Relapse prevention should be addressed with every former tobacco user (see Annotation K – Initiate/Reinforce Relapse Prevention). [Expert Consensus]
DISCUSSION
During 1993-2000, substantial reductions in current smoking prevalence were reported in the United States for all age groups, except those aged 18 to 24. An additional issue of tobacco use in this age group is the fact that this group has shown a 13 percent use of smokeless tobacco (CDC, 2002). According to military demographic data, the age of military recruits falls within this age range (Haddock et al., 2001). Studies show that between 34 to 60 percent of recruits entering the military utilized some form of tobacco prior to entering the initial phase of military training (Chisick et al., 1998; Haddock et al., 1998; Williams, 2001a). Studies have also shown that the enforced abstinence during basic military training resulted in a 26 percent rate of abstinence after basic training for those previous users of tobacco. Three studies found that approximately 74 percent of graduated recruits resumed their tobacco use, with approximately 6 to 11 percent initiation of tobacco use after graduation among previous non-tobacco users (Haddock et al., 1998; Hurtado & Conway, 1996; Williams et al., 1996).
One promising DoD program designed to take advantage of the tobacco-free recruit environment is the Navy’s Reinforcing Education to AChieve Health (REACH) Program. This program introduces recruits to the impact of tobacco use on military readiness, health benefits to not using tobacco, and financial benefits of being tobacco-free that will result from graduated trainees continuing their tobacco-free lifestyle. This multifaceted program has resulted in a 50 percent reduction in tobacco use resumption within 30 days of recruit graduation and a 67 percent reduction of tobacco-use initiation (Williams, 2001a; Williams, 2001b).