Military tobacco use: A synthesis of the literature on prevalence, factors related to use, and cessation interventions

Tobacco use remains the number one cause of preventable morbidity and premature death in the United States. As a result, military leaders are recognizing that tobacco can adversely affect military fitness levels, deployment readiness, and safety and can increase health care costs. Yet military members continue to use tobacco. Tobacco may be viewed as part of the military culture since military members have used tobacco for many decades for pleasure, comfort, and currency and as a morale booster. Most recently, the military has seen an increase in tobacco use among young military members. A number of research studies have examined the prevalence of tobacco and factors related to use in the military, and several have evaluated cessation and prevention interventions. This article provides a brief historical perspective of military tobacco use in the 20th century and a critical review of the literature published between 1991 and 2006 describing prevalence of tobacco use, factors influencing use, and cessation interventions in the military. Recommendations for future research and for interventions are provided.