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thedrifter
10-29-08, 08:27 AM
U.S. troops in Iraq are heavy smokers
2:27 PM, October 28, 2008

American sailors and Marines stationed in Iraq are more than twice as likely to use tobacco products as the average American, according to a study presented today at the annual meeting of the American College of Chest Physicians.

In a survey of 408 Marines and sailors, Dr. Michael A. Wilson found 64% used some form of tobacco: 52% smoked cigarettes, 36% used smokeless tobacco and 24% used both. In contrast, the national average for tobacco use is 29.6%. Wilson found the rate of tobacco use is higher now among U.S. troops in Iraq than was found in a 2004 survey of troops returning from the war.

Tobacco use was clearly linked to military service. About half of those surveyed said they had never used tobacco products before joining the military. Eighty percent of the smokers said that being in the military had increased their use while 72% stated that being deployed to Iraq had increased their smoking. Smokeless-tobacco users also said being in the military and being in Iraq increased their usage. Overall, 74% of the troops who use tobacco said they wanted to quit.

Some controversy has surrounded the military's efforts to discourage tobacco use. Smoking among the troops has always been linked with deployment to foreign lands, but much more is known today about the health hazards of smoking, said Wilson, who is stationed with the U.S. Navy, 3rd Battalion, 23rd Marine Regiment, 4th Marine Division, New Orleans.

"There is a culture of acceptance about tobacco in the military. It's embraced by the leadership. A lot of the leadership use tobacco. They learned it from the people they trained with, and it gets passed on."

Wilson conducted the survey while stationed in Iraq and said that troops told him they used tobacco for a variety of reasons: peer pressure, to emulate leaders they admire, boredom, stress relief and to help them stay awake. But, he said, tobacco use is likely to have a greater negative impact to the long-term health of Iraq War veterans than combat-related injuries. The cost of care for troops with tobacco-related health problems will also soar for both the VA and U.S. healthcare systems.

The Defense Department recently launched a virtual anti-smoking campaign targeting enlisted personnel between ages 18 and 25 called "Quit Tobacco, Make Everyone Proud." The Department of Veterans Affairs also has a website on smoking cessation. But more effort should be spent to discourage tobacco use among newly enlisted troops and to discourage smoking in the war zone, Wilson said in an interview with The Times.

"My point is that we have to get them ready to survive Iraq and survive beyond Iraq. Everyone realizes this is a problem. But you need the leadership on a macro level, from the general on down, to the micro level, to get on board because that is who the kids really look up to."

-- Shari Roan

Photo credit: Roslan Rahman/AFP/Getty Images

http://www.publichealth.va.gov/smoking/



Ellie

thedrifter
10-29-08, 08:32 AM
Today's Smokers More Addicted to Nicotine
The less-hooked may have already quit, leaving 'hard-core' group behind, experts say
Posted October 28, 2008


By Steven Reinberg
HealthDay Reporter

TUESDAY, Oct. 28 (HealthDay News) -- Almost 75 percent of current smokers trying to kick the habit are now highly nicotine-dependent, which is a 15-year high, a new study finds.

In fact, nicotine dependence has risen 12 percent from 1989 to 2006, and the number of highly nicotine-dependent people has gone up 32 percent, according to research expected to be presented Tuesday at the American College of Chest Physicians annual meeting, in Philadelphia.

Nicotine dependence can vary from smoker to smoker, experts noted.

"My clinical perception has been that over the last five years, patients that I am seeing require much more intensive treatment because tobacco dependence is more severe," said lead researcher Dr. David P. Sachs, from the Palo Alto Center for Pulmonary Disease Prevention in California.

Studies have shown that the more nicotine-dependent an individual is, the less effective standard treatment will be, Sachs said. "These people will suffer severe nicotine withdrawal symptoms, and they will be more likely to relapse back to cigarette use," he explained.

For the study, Sachs' team compared the degree of nicotine dependence between 1989 and 2006 in three groups of smokers, a total of 630 in all, who enrolled in smoking cessation programs.

Nicotine dependence was measured using the Fagerstrom Tolerance Questionnaire, which assesses nicotine dependence on a scale of 0 to 11 points.

Over 15 years, scores on the questionnaire increased by 12 percent, and the number of people with scores of 7 to 11 went up 32 percent. Overall, the proportion of people who were highly nicotine-dependent rose from 55.5 percent to 73 percent over the study period, Sachs' group found.

Sachs believes that it's the most nicotine-dependent smokers who are now showing up at quit-smoking programs. "If these patients are going to get effective treatment and not be at risk for relapse, they need more intensive treatment," he said.

About 10 percent of smokers are actually not nicotine-dependent, Sachs said. "These are smokers who can stop 'cold turkey' and not experience physical nicotine withdrawal symptoms. It's really a matter of willpower for them," he said.

Once those smokers have stopped, "that leaves the people who are genetically dependent on nicotine," Sachs said.

Dr. Norman H. Edelman is a professor of preventive medicine, internal medicine, physiology and biophysics at Stony Brook University in New York and chief medical officer of the American Lung Association. He said there could be several explanations for the increase in degree of nicotine dependence among current smokers.

"I agree with the author's conclusions with regard to increasing difficulty to be expected in achieving smoking cessation," Edelman said. "This may be the reason rates of smoking cessation have been declining."

There may, however, be other reasons for the increase in nicotine dependence, Edelman said. "Is the reason for the increase in nicotine addiction due to the fact that cigarette companies have been increasing the nicotine content of cigarettes? Is the reason for this finding the fact that we have been successful with the less-addicted, and now have the more addicted 'hard-core' [smokers] left?" he asked.

In another study, also expected to be presented at the meeting Tuesday, U.S. Navy researcher Michael A. Wilson reported that the prevalence of smoking among Marines and sailors serving in Iraq is more than two times the U.S. average.

Wilson found that of 408 Marines and sailors in Iraq, 64 percent used some form of tobacco, much higher than the U.S. national average for tobacco use (29.6 percent), and a big jump from the 38.9 percent of troops using tobacco in a similar survey conducted in 2004.

Cigarette smoking accounted for 52 percent of tobacco use, followed by smokeless tobacco (36 percent) and the use of both (24 percent). Most of the troops surveyed (74 percent) said they wanted to quit.

The long-term consequences of increased smoking are worrisome, Wilson warned. "This study indicates the prevalence of tobacco abuse in combat units deployed to Iraq is substantially higher than the national average," he wrote. "Such abuse will likely cause a greater negative impact on the long-term health of U.S. veterans than combat-related injuries and will have great financial consequences for both VA and U.S. health-care systems," he concluded.

More information

For more on how to quit smoking, visit the National Institutes of Health.

Ellie