Navy tightens tobacco restrictions for medical personnel
By David Carter, Stars and Stripes
Pacific edition, Sunday, April 5, 2009

YOKOSUKA NAVAL BASE, Japan — Most U.S. Navy medical personnel in the Pacific — military and civilian — will be banned from smoking or chewing tobacco anywhere during duty hours and while in uniform, in accordance with a recent Navy instruction.

Capt. Kevin Moore, commander of U.S. naval health care facilities in Japan, South Korea and Diego Garcia, said during a phone interview Friday that he and his staff are taking the instruction seriously and have begun enforcement.

"I was once asked, ‘How can you call yourself a health care organization when you’re allowing people to kill themselves in front of you?’ " Moore said. "It’s a really good question and I think this policy is really helpful in us saying we’re not going to support self-injuring behavior."

According to the Navy instruction, the Chief, Bureau of Medicine and Surgery shall "prohibit military personnel from using tobacco products while in the presence of patients or while in uniform when representing Navy Medicine."

Moore said specific guidance regarding enforcement with the civilians is still being sought.

"We as health care providers have to be held accountable to being good role models," he said.

Branch health clinics at Naval Air Facility Atsugi, Marine Corps Air Station Iwakuni, Sasebo Naval Base, Negishi Housing Area in Japan and Chinhae Naval Base, South Korea, are following suit.

"We’re in the process of educating people about the no-smoking policy," Moore said. "We have the chiefs patrolling the areas reminding our folks about the instruction."

The Navy medical community on Okinawa, which falls under a separate command, is also following the general guideline.

Kiyomi Williams, spokeswoman for the U.S. Naval Hospital on Okinawa, said medical staff have been prohibited from smoking during their workday since January. But the policy is enforced only on the hospital grounds and is based on the honor system, she said.

When asked how the ban might affect staff performance given the possible unpleasant withdrawal symptoms associated with quitting smoking, Moore said he’s not expecting any issues.

"Some of the inpatient wards that I’ve worked at in the past have gone smoke-free, and surprisingly, there was very little impact," he said. "We are going to be concerned, though, because it is a very difficult substance to give up, and I don’t want to minimize it and just say just quit."

The hospital offers such products as nicotine gum and patches to help people quit smoking, Moore said.

The Yokosuka hospital also plans to start tobacco cessation classes for staff in the future. Patients now are being referred to their primary care managers.

The smoking ban has one key beneficiary in mind — the patient.

"As a patient, it’s very distracting and not a pleasant experience to be around someone who’s been smoking," Moore said. "More importantly, though, I don’t think it’s a good thing for their health."

Some hospital patrons agreed.

"I think it’s a great idea," said Maria Diaz, a Navy spouse in Yokosuka. "I don’t like smelling cigarettes, and especially not in the hospital. It doesn’t give you the impression that they’re creating a healthy environment."

But Chantal Sheehan, a Navy employee from Atsugi who works at Camp Zama’s orthodontics department, said she doesn’t agree with the Navy’s position. Sheehan, a smoker, says it’s indicative of a broadening anti-smoking bias on the part of the military.

Sheehan pointed to base stores raising the prices of tobacco products as an example of that trend.

"Well, if they’re going to do it for tobacco, then they have to do it for alcohol, fatty foods, everything else that’s bad for you," said Sheehan.

"They can’t just do it to smokers."

Moore said the hospital plans to release its final official tobacco policy on May 31 during World No Tobacco Day.

U.S. Navy officials on Guam, queried early in the week, were unable to comment on their smoking policies by deadline Friday.

Stars and Stripes reporters Natasha Lee and Tim Wightman contributed to this story.

Smoking guidelines around the Pacific

Japan

Misawa Air Base: Officials banned all smoking on the 35th Medical Group campus, including inside cars, beginning Feb. 15. The policy applies to staff, patients and visitors.

Camp Zama: Medical personnel are allowed to smoke during their breaks in designated smoking areas.

Yokota Air Base: Information unavailable by deadline Friday.

South Korea

Kunsan and Osan air bases: While smoking is discouraged, Air Force medical personnel are allowed to smoke during their breaks in designated smoking areas.

65th Medical Brigade: Information on smoking policies for the brigade, which administers health care for the Army in South Korea, was unavailable by deadline Friday.

Okinawa

Kadena Air Base: The Air Force’s tobacco use policy, AFI 40-102, is under revision, but the 18th Medical Group at Kadena adheres to the most recent version which allows smoking in designated smoking areas around the facility.

Ellie