Raising tobacco prices and expanding tobacco-free areas on military bases are two options for discouraging use that will be presented to Defense Secretary Ash Carter by an advisory committee, according to a defense spokeswoman.
It's unclear how high the prices might go in military stores. The option being considered is "matching the average price paid for tobacco," said defense spokeswoman Laura Seal.
A recent change in law requires that prices can't be any lower than the lowest price in the surrounding civilian community for that product. But unlike the previous policy, the new law doesn't set a ceiling on how high tobacco prices can go. That will be left to the Defense Department to determine, one Air Force official said.
The Air Force, in a March instruction, has already expanded the number places where tobacco use is prohibited. It is no longer permitted in recreation facilities, including its bowling alleys, beaches, parks, golf courses and basketball courts. Smoking in vehicles is no longer permitted on Air Force medical campuses, or when there's a child in the car under age 14. The instruction also prohibits tobacco use while in uniform for students in technical training, accession and graduate medical education programs.
"In the Air Force, we're committed to promoting tobacco-free living throughout. We're not waiting for direction from DoD. We'll continue to push forward," said Air Force Col. (Dr.) John Oh, chief of health promotion for the Air Force Medical Support Agency.
"We're not doing anything in the Air Force that isn't being done elsewhere," he said. "We're following many of the practices that have been shown to be effective." The tobacco policies are part of a broader strategy to improve the health and fitness of airmen, their families and retirees.
Oh was a member of a working group that provided input to the Defense Advisory Committee on Tobacco. He said the recommendations are grounded in science — if there are more tobacco-free areas, there is a decrease in tobacco use. If prices of tobacco go up, the use of tobacco decreases.
"The continued persistence of cheap tobacco in military exchanges is a source of confusion for airmen," Oh said. "It sends a mixed message. If it's so important to have tobacco-free living, why do we have cheap tobacco in the exchanges?" he said.
"Matching the average price" of civilian stores would presumably factor in the highest-price products, which would increase tobacco prices.
Information was not available at press time about when the Defense Advisory Committee on Tobacco will present the options to the defense secretary. The committee of senior leaders was formed last June to find ways to reduce tobacco use throughout DoD.
The committee was chartered by the undersecretary of defense for personnel and readiness to provide recommendations on a "Department of Defense Comprehensive Tobacco Control Plan."
Last year, defense officials ordered a comprehensive look at tobacco policies from a variety of perspectives, and the target date for the services to recommend changes in tobacco policies on military installations was the end of last year.
A DoD memo in March 2014 appeared to encourage the services to eliminate tobacco sales — and tobacco use altogether— on military bases, while stopping short of ordering specific actions. "Structural reforms in how and where we allow tobacco purchases to be made; as well as the need to consider tobacco-free installations, are all matters that require our near-term attention," stated the memo, signed by Jessica Wright, then-undersecretary of defense for personnel and readiness, and Dr. Jonathan Woodson, assistant secretary of defense for health affairs.
They noted that tobacco use costs the department an estimated $1.6 billion a year in medical expenses and lost work time. Based on statistics that half of smokers will die from a related complication, about 175,000 current active-duty smokers will die, the officials wrote.
Smoking has been prohibited in workplaces on military installations for about 20 years. Tobacco sales on military bases have steadily declined since defense officials began taking steps to reduce smoking in the ranks, to include reducing the discounts on tobacco products.
Information was not available about whether officials are still considering the option of tobacco-free installations. Seal said the tobacco committee will present the option of increasing the size and number of tobacco-free areas, "particularly where exposure to second-hand smoke may be a concern." Oh said second-hand smoke is particularly a problem for children.
Other strategies include countermarketing to provide information on the effects of smoking, as well as improving access to tobacco-cessation products, Oh said. Those are part of the committee's initiatives. DoD and the services have long been working to decrease the use of tobacco, with efforts such as www.ucanquit2.org.
In March 2014 the Navy was reportedly on track to eliminate tobacco sales on Navy and Marine Corps bases. But that was put on hold after defense officials ordered the comprehensive departmentwide review of policies.
Meanwhile, lawmakers moved to stop DoD from banning the sale of tobacco on bases, including a provision in the 2015 National Defense Authorization Act that prohibits DoD from banning the sale within military retail stores of any legal consumer tobacco product category.
In an effort to prevent deep discounts on tobacco, lawmakers also changed the pricing policy, preventing military retail stores from selling a tobacco product at a price below the most competitive price for that product in the local civilian community.
That was already the policy for Navy and Marine Corps outlets. The Army and Air Force Exchange Service implemented the change Jan. 19. Previously, it was aligned with DoD policy, which stated that tobacco prices could be no higher than the most competitive price, and no lower than 5 percent below that most competitive price. The December change in effect eliminated the 5 percent discount, and doesn't specify a cap on prices.