By André B. Sobocinski, BUMED Historian
At the end of the 1970s, Secretary of Health Education, and Welfare Joseph Califano, Jr. famously called tobacco “Public Enemy No. 1.”(1)
Following Califano’s lead, the Navy Medical Department took the fight against King Tobacco to its hospitals at decade’s end. Surgeon General Vice Adm. Willard Arentzen, called all healthcare professionals who smoked “derelict” from their duties and they needed to lead the fight against tobacco by example.(2) In a “Dear Doctor” letter to all naval hospital commanding officers dated September 1977, Arentzen wrote, “As health care professionals we must encourage programs to decrease morbidity and premature mortality, including decreasing tobacco smoking.” (3)
The very same year was marked by DoD’s first policy on reducing smoking in the workplace and, also, the development of an anti-smoking program targeting high-risk groups (i.e., chronic bronchitis, asthmatics, and asbestos workers) (4). Nationally, the American Cancer Association inaugurated its first “Great American Smokeout” campaign, an event the Navy and Marine Corps has been part of ever since.(5)
By the 1980s, it was clear that tobacco use was a bigger problem for the Armed Services than the greater civilian population. A 1983 Department of Defense survey found that 56 percent of males and 48 percent of women in the military smoked; this compared with 36 percent of males and 29 percent of females in the greater civilian population.(6) Four years later, a DoD survey found that 44 percent of all Navy personnel smoked compared to 29 percent of all civilian adults.(7)
Despite these statistics, progress was being made against King Tobacco. In January 1987, Naval Hospital Camp Pendleton, Calif. became the first “smoke-free” military hospital in the United States.(8) Two years later tobacco was banned in all Navy and Marine healthcare facilities; and seven years later the Department of Defense Instruction 1010.15 prohibited smoking in all DoD workplaces. In 1994, the Pentagon would make history as the largest smoke-free office building in the world.(9)
Even though King Tobacco’s dominion continues to be chipped away through increasingly restrictive tobacco control policies and healthcare promotions, his presence remains. Today it is estimated that 20 percent of military personnel smoke and 13 percent use smokeless tobacco. Tobacco-related illnesses in the military are estimated to cost $1.6 million annually.(10)
(1) Moyer, David. The Tobacco Reference Guide. (www.tobaccoprogram.org)
(2) “Navy MDs Who Smoke Shouldn’t.” U.S. Medicine, October 15, 1977.
(3) Arentzen, Willard. “Dear Doctor,” September 21, 1977. BUMED Archives.
(4) DoD Instruction 6015.18. “Smoking in DoD Occupied Buildings and Facilities,” dated August 18, 1977.
(5) “History of the Great American Smokeout.” (www.cancer.org)
(6) Conway, Terry and T.A. Cronan. “Smoking and Physical Fitness Among Navy Shipboard Personnel.” NHRC Report No. 86-33. 1986.
(7) Conway, Terry, Suzanne Hurtado, and Susan Woodruff. “Tobacco Use Prevention and Cessation Programs in the U.S. Navy.” Public Health Reports. January-February 1993, Vol. 108, No. 1.
(9) DoD Instruction 1010.15 “Smoke-Free DoD Workplace.” Dated March 7, 1994.
(10)Shane, Leo. Senate panel proposes ending tobacco discounts on bases. Air Force Times. August 4, 2014. p6