<--GAT-->

Repercussions of High Military Smoking Rates Affect Health Systems

by U.S. Medicine

April 4, 2014
WASHINGTON – The U.S. military’s love affair with tobacco may be officially over, but the federal healthcare system is still dealing with the aftermath, especially chronic conditions such as chronic obstructive pulmonary disease (COPD). The DoD now has an intense focus on smoking cessation, but that is a more recent development. Cigarettes were included in C-rations until 1975, and World War II advertisements for smoking often featured servicemembers in uniform.
Current Smoking Among Men Aged 25 to 64 Years, by Age Group and Veteran Status — National Health Interview Survey (NHIS), United States, 2007 to 2010

Current Smoking Among Men Aged 25 to 64 Years, by Age Group and Veteran Status — National Health Interview Survey (NHIS), United States, 2007 to 2010.  Click figure to expand in new tab.

Even now, cigarettes are sold discounted at military bases throughout the world, although the VA has banned the sale at retail outlets in its VAMCs. More than 30% of military personnel smoke, a rate 50% more prevalent than in the civilian population, according to an Institute of Medicine (IoM) report in 2009. The smoking rate during deployment has been estimated to be as high as 50%. Smoking rates also remain considerably higher among veterans than the civilian population, according to the national Centers for Disease Control and Prevention. The CDC reports that, in men aged 25–64 during 2007–2010, 29% of veterans reported being current cigarette smokers, compared with 24% of those who had not served in the military. The rates are especially high among middle-aged veterans, with 36% of 45-54-year-old veterans reporting that they currently smoke, compared with 24% of those who had not served in the military. It should come as no surprise, therefore, that COPD is the fourth most common diagnosis among hospitalized veterans. “Within VA, COPD is about four times more prevalent than in the general population, largely because of tobacco exposure and the high rate of current and past tobacco use. Research shows that smoking accounts for about 80% of COPD deaths,” said David Au, MD, investigator in the VA’s Northwest Center of Excellence and associate professor of medicine and pharmacy at the University of Washington in Seattle. “The No. 1 treatment is tobacco cessation, which in a 14-year randomized clinical trial, the Lung Health Study in 2005-2006, was clearly shown to reduce mortality.” The number of COPD patients is likely to increase beyond the about 1 million currently treated at the VHA. A report from the House Committee on Veterans’ Affairs estimated that prevalence of airflow limitation is 33%-43% among VHA patients, indicating high rates of undiagnosed disease. Already, the long-term costs are nothing short of astronomical. The VA spent more than $6 billion in 2008 treating diseases such as COPD. The IoM found, meanwhile, that DoD’s cost of treating tobacco-related diseases is estimated to be more than $500 million per year for medical care and $346 million in lost productivity. In the active-duty military, patients who respond to simple therapy have no service restrictions, but the need for medication to manage chronic disease can limit service. Another factor that could affect future COPD rates is the number of troops exposed to burn pits, dust, chemicals and other environmental risk factors, particularly in Iraq and Afghanistan. Currently, respiratory cancers are considered presumptively service connected to herbicide exposure (i.e. Agent Orange), but restrictive lung diseases such as COPD are not.

2 Comments

  • toni chiara says:

    restrictive lung diseases such as COPD – stands for: Chronic Obstructive Pulmonary Disease – it is an obstructive lung disease. Individuals with copd may have a mixed form of lung disease with restrictive and obstructive components – BUT COPD IS NOT GENERALLY CONSIDERED A restrictive lung disease

  • toni chiara says:

    restrictive lung diseases such as COPD – stands for: Chronic Obstructive Pulmonary Disease – it is an obstructive lung disease. Individuals with copd may have a mixed form of lung disease with restrictive and obstructive components – BUT COPD IS NOT GENERALLY CONSIDERED A restrictive lung disease


Related Articles

Oral Cancer Therapies Create Critical Demand for Pharmacists

CHICAGO—The pace of U.S. Food and Drug Administration approval of oral anticancer medications has rapidly increased, from less than one a year at the turn of the century to 10 in 2018. While patients generally... View Article

DCVAMC Acting Pharmacy Chief Ivan Cephas: ‘Caring Is the Reason’

WASHINGTON—Ivan Cephas, PharmD, the acting chief of pharmacy at the DCVAMC, would be the first to say that what he does is not above and beyond the call of duty. Despite having been awarded the... View Article


U.S. Medicine Recommends


More From pharmacy

Pharmacy

Oral Cancer Therapies Create Critical Demand for Pharmacists

A new study looks at factors to improve survival rates in veterans with multiple sclerosis. VA’s efforts don’t stop there, however. The healthcare system has a multipronged effort to reduce disability and improve quality of... View Article

Pharmacy

DCVAMC Acting Pharmacy Chief Ivan Cephas: ‘Caring Is the Reason’

A new study looks at factors to improve survival rates in veterans with multiple sclerosis. VA’s efforts don’t stop there, however. The healthcare system has a multipronged effort to reduce disability and improve quality of... View Article

Pharmacy

New Military Pharmacy Program Frees Patients from Long Waits

More than a dozen military treatment facility pharmacies have implemented a pilot customer service system that gives patients greater control over how they spend their time while waiting for prescriptions to be filled.

Pharmacy

New Venous Thromboembolism Guidelines Could Change Treatment at VA

Venous thromboembolism, which includes deep venous thrombosis and pulmonary embolism, is the most common preventable cause of hospital death, according to the VA.

Pharmacy

Use of Non-VHA Pharmacies Increases Risks of Scheduled Drug Overdoses

Using multiple sources to get prescribed pain medications and other Schedule II through V drugs increases risks for veterans, a new study finds.

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up