"The military, which is its own subculture, still has one of the highest rates of tobacco use of any occupational group, both smoking and smokeless," said lead study author Walker S. Carlos Poston, Ph.D., M.P.H. at the Institute for Biobehavioral Health Research of the National Development and Research Institutes, Inc.
Veterans service organizations (VSO) should provide more online support for smoking cessation, the authors said, because "veterans who smoke are less likely to quit, they have been specifically targeted by the tobacco industry, and there is evidence that the military still provides a supportive atmosphere for tobacco use and initiation, such as substantially discounted cigarettes for active military and eligible veterans and retirees and the lack of consistent tobacco control policy enforcement."
Researchers evaluated websites for veteran service organizations such as the American Legion, Disabled American Veterans and Veterans of Foreign Wars, all of which differ substantially in the range of veterans they serve. They found 277 health topics addressed on 24 websites, the top five of which were insurance issues, post traumatic stress disorder (PTSD), disability and amputation, Agent Orange, and traumatic brain injury.
"Tobacco-related content was virtually nonexistent," they said. Tobacco was mentioned only 4 times across all 24 websites and smoking cessation was never mentioned.
Tobacco use impacts active military and veterans with smoke-related illnesses like pulmonary and cardiovascular diseases and cancer, and worsens PTSD symptoms. It also negatively impacts family members-due to increased health care costs and caregiver burdens.
The military does offer a free state-of-the-art "quit smoking" program, and a telephone quit line for active duty and veterans, Poston said. "That's good, since smoking costs the military a lot more than other habits, including overeating and resulting problems of overweight and obesity."
The authors suggested a number of concrete ideas to increase VSO awareness and engagement around the topic of tobacco use. For example, providing VSOs with training for smoking cessation peer interventionists for prospective quitters and encouraging VSOs to include smoking cessation materials on their Web sites and provide links to the respective state quit telephone lines and other public domain smoking cessations resources, including the American Lung Association, the American Heart Association, the National Institutes of Health and the American Legacy Foundation.
"I can't say I'm shocked by the findings. It was both impressive and depressing how little mention there was of tobacco use or smoking cessation on the websites," said Harry A. Lando Ph.D., a professor at the University of Minnesota's School of Public Health''s Division of Epidemiology and Community Health. "But I would have thought there'd be at least more mention of tobacco on the websites."
The military can be a breeding ground for taking up smoking, he said. "It seems it would be very low cost to implement some of the recommendations the authors made, to put some of that information on websites about quitting, or to include other resources."