Three in 10 U.S. veterans used some form of tobacco during 2010-2015—a higher number than among nonveterans across all age groups except men aged ≥ 50 years, according to a CDC analysis of data from the National Survey on Drug Use and Health. More than one-third of the veterans surveyed started smoking after enlisting.
The analysis also found that > 60% of the veterans who used tobacco products had no health insurance, more than half were living in poverty, and 48% reported serious psychological distress.
The toll is significant not only for the smokers and their families, but also for the health care system. The researchers estimate that during 2010, VHA spent nearly $3 billion on smoking-related ambulatory care, prescription drugs, hospitalization, and home health care.
“VA has more tobacco use treatment options available than ever,” said Kim Hamlett-Berry, PhD, program director of VA Tobacco and Health Policy, and that has led to declines in rates of smoking. She notes that the 2015 VA Survey of Enrollees reported that 16.8% of veterans enrolled for health care in VA identified as a current smoker.
In addition to the quit lines already available (800-QUIT-VET, 800-QUIT-NOW, and https://smokefree.gov/VET), veterans can access quit services through TRICARE. VA treatment centers also have integrated smoking cessation programs into treatment for PTSD and other disorders. Smokers with psychiatric illness are more likely to die of smoking-related diseases than of complications from their mental illness or substance use disorders, Hamlett-Berry said at an American Psychological Association conference in 2013. She added that people with alcohol dependence and other substance use disorders smoke at higher rates. Research shows that combining smoking cessation with substance use treatment increase patients’ likelihood of success.
The CDC says more can be done. Strategies could include promoting cessation to current military personnel and veterans, implementing tobacco-free policies at military installations and VA medical centers and clinics, increasing the age requirement to buy tobacco on military bases to 21, and eliminating tobacco product discounts through military retailers.