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WASHINGTON, DC—DoD health officials will increase the number of servicemembers and their families it helps quit smoking. “We are focusing on getting people the resources that they need to help them quit,” said US Public Health Service Cmdr Aileen Buckler, MD, population health physician analyst at TRICARE. “Smoking is an addiction that is a difficult habit to break and it takes about seven quit attempts for a person to be successful in quitting.”
Smoking among servicemembers has been worrisome to health officials. The 2008 DoD Survey of Health Related Behaviors Among Active Duty Military Personnel found that the rate of any past month smoking among DoD services was at 31% in 2008.
An Institute of Medicine report that was released in 2009, Combating Tobacco in Military and Veteran Populations, concluded that to prevent tobacco initiation and encourage cessation, both DoD and VA should implement comprehensive tobacco-control programs.
Buckler noted that many of the recommendations in the report confirmed what DoD is trying to do to curb smoking, such as “putting in place counseling, counter-marketing campaigns, and a lot of the resources available on the Web. We are also trying to break through some barriers, such as making counseling and programs available when people are able to get to them.”
TRICARE Smoking Cessation Program
The 2009 National Defense Authorization Act (NDAA) has given TRICARE additional authority to tackle smoking. The law authorized a TRICARE smoking cessation program that includes counseling, toll-free quit-line help, no-cost smoking cessation medications, and available print and online tobacco cessation education materials. While the individual services have smoking cessation programs, prior to the passage of the 2009 NDAA TRICARE was prohibited from paying for tobacco cessation programs.
Buckler explained that the tobacco cessation counseling benefit authorized by the law is now available and will be particularly helpful for those beneficiaries living far from an installation, but who desire counseling. “A lot of the medical treatment facilities and installations already had their own programs and classes and counseling available on their installations, but there was not anything easily available for those who did not live close to one. This new benefit will allow those people to take advantage of that counseling.”
In addition, help-lines for those who want assistance in quitting smoking were put in place in June of 2010 and are available 24-hours-a-day, 7-days-a-week, according to Buckler. The quit-line is a telephone support and referral service. “They have trained smoking cessation coaches that are available at any time and they can help assess what stage of quitting a patient is in, and then help direct them to resources in their community, as well as help them set up a personalized quit plan. They can also mail them educational materials related to quitting.”
Officials are working on the implementation of a smoking cessation pharmaceutical benefit that was laid out in the 2009 NDAA. The smoking cessation pharmaceutical benefit requires a change to the Code of Federal Regulations for implementation. This revised language is currently in the proposed regulatory pathway, which has defined procedures and steps that lead to publication of the final rule.
Reaching Beneficiaries through the Web
Web resources are also being used to reach servicemembers and their families. DoD sponsors an educational campaign for the military called “Quit Tobacco—Make Everyone Proud,” which was launched in February 2007.
The website, www.ucanquit2.org, includes tools to help users quit as well as campaign material and the latest news on smoking. The website also launched a new online support system called “Train2Quit” in 2010. The training offers a step-by-step process for tobacco users who want to quit. With the training users can stop and restart at any time, track their progress, and receive a certificate of completion when they have finished the training.
Recently, access to the chat room function on the campaign website was expanded from active duty military personnel to include veterans and all TRICARE beneficiaries not eligible for Medicare.