Congressional efforts to limit or even stop men and women in the military from smoking cigarettes or using other tobacco products could create a major morale problem for front-line troops.

The Joint Chiefs of Staff see it coming and hope to get out in front of it.

Wednesday, during the Senate Appropriations defense subcommittee hearing on the fiscal 2015 defense budget, the panel’s chairman, Sen. Richard J. Durbin (D-Ill.), questioned the discount prices for tobacco products sold within the Defense Department. “We spend $1.6 billion a year on medical care of service members from tobacco-related disease and loss of work,” he said.

Gen. Martin E. Dempsey, chairman of the Joint Chiefs, responded, “We’ve asked a lot of our men and women in uniform, and we lead an uncommon life by choice. But all the things you’re talking about are legal, and they are accessible, and anything that makes anything less convenient and more expensive for our men and women in uniform, given everything we’re asking them to do, I’ve got concerns about.”

Dempsey concluded, “I want to make sure that you understand that the chiefs will need to have a voice on this because of the effect on the force.”

Reducing smoking in the military has been a creeping campaign for almost 30 years, starting with congressional efforts in 1985 to raise commissary cigarette prices to equal those in civilian stores. Instead of raising prices, then-Defense Secretary Caspar Weinberger set up an “aggressive anti-smoking campaign” after a 1986 Pentagon study showed military smokers were less physically fit than non-smokers and tobacco-related health costs might reach $209.9 million.

Other steps and other studies have followed. At Wednesday’s hearing, Defense Secretary Chuck Hagel said he has ordered a review of all tobacco sales as part of a study of all health programs. On March 14, a department memo titled “Reducing Tobacco Use in the Armed Forces and the Department of Defense” noted department policies have “made great progress in reducing tobacco use. Yet our work is far from over.” The memo, which went to the service secretaries and the military chiefs of staff, set as a goal “to dramatically reduce use of all tobacco by 2020,” with proposed structural reforms such as where tobacco purchases should be made and “the need to consider tobacco-free installations.”

Face it. In the U.S. military, smoking cigarettes hasn’t just been accepted, it’s been important. I’ve never smoked, but I grew up during World War II when Bill Mauldin’s famous cartoon GIs had cigarettes dangling from their lips. So did Ernie Pyle, that war’s most famous war correspondent.

As late as 1975, cigarettes were part of soldiers’ rations. Since then, a new attitude has developed as steps were taken to discourage smoking. In 1994, the Pentagon banned smoking in workplaces and set up designated smoking areas. A 1997 executive order went further, banning smoking in all government-owned, rented or leased interior spaces. After a phase-in period, the Defense Department fully implemented that policy in December 2002.

To some degree, the Navy has led the way by eliminating smoking breaks and setting up smoking areas in offices, surface ships and submarines in the 1990s. In 2010, it banned all smoking on submarines.

The department’s actions have had some effect. In 1985, all military smoking was at 47 percent. It’s dropped to 30 percent. However, as the March 14 memo states, “An estimated 175,000 current active duty service members . . . will die from smoking unless we can help them quit.”

Durbin pointed out that the rate of smoking among the military is 20 percent higher than the overall U.S. civilian rate and that service members’ use of smokeless tobacco has gone up to more than 400 percent higher than the U.S. average.

“One out of three members of the military who use tobacco today say they started after they enlisted,” Durbin added.

The last major military smoking study, requested by the Pentagon in 2007 and completed by the Institute of Medicine in 2009, found that “smoking rates among military personnel returning from Iraq and Afghanistan may be 50 percent higher than rates among nondeployed military personnel.”

The institute’s study said, “Current cigarette use in the military is more likely among men, those who are white, have less than a college education, are younger than 34 years old, and are enlisted versus officers.”

In 2005, smoking rates for 18-to-25-year-old military men was high at 42.2 percent, although it varied by service, with the Army and Marines being highest, and the Air Force the lowest.

In short, smoking is highest with those most likely to be involved in fighting on the ground. A 2008 study found that “smoking rates increased by 57 percent among those deployed and by 44 percent among those not deployed.”

Last March, when Stars and Stripes carried a story about Navy Secretary Ray Mabus considering a ban on all tobacco sales on ships and bases, the comments received previewed what could come if more actions are taken.

“THIS IS OUT OF CONTROL!!!!,” wrote one ex-Marine. “When I was sitting in a bunker in Vietnam at 0400, a cigarette gave me comfort and pleasure. OH!!!! It is not good to get lung cancer but a sucking chest wound is???”

Dempsey was more diplomatic: Because smoking is legal, taking more steps to halt it “is an issue for the broader Congress of the United States, not uniquely for the United States military.”

Rep. Duncan D. Hunter (R-Calif.), a Marine Reserve major with three combat tours in Iraq and Afghanistan, has already acted. He argued at one point: “We sleep in the dirt for this country. We get shot at for this country. But we can’t have a cigarette if we want to for this country, because that’s unhealthy.”

He got the House to approve his prohibition of any new restrictions on legal products — including tobacco, sold on military bases, commissaries, post exchanges, and even ships — added to the fiscal 2015 Defense Authorization Bill.

Let’s see what the Senate does.

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