Tobacco Harm Reduction Strategies for U.S. Service Members

Tobacco use remains prevalent among U.S. service members, with approximately 30 percent engaging in tobacco products, a rate significantly higher than the general population. According to 2018 Pentagon data, 37.8 percent of active-duty personnel reported using tobacco or nicotine products, including 18.4 percent who smoked cigarettes and 13.4 percent who used chewing tobacco. In contrast, the Centers for Disease Control and Prevention (CDC) estimated the cigarette smoking rate among U.S. adults in 2022 at 11.6 percent.

The Hill

During a recent event hosted by The Hill, experts discussed the potential of smokeless nicotine products as a "bridge" to quitting combustible cigarettes for military personnel. Stephen Ferrara, Principal Deputy Assistant Secretary of War for Health Affairs, emphasized the importance of nicotine replacement therapies in reducing the health risks associated with smoking. He noted that many service members suffer from health issues linked to smoking, such as critical limb ischemia and stroke.

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Ferrara stated, “We’re trying to get folks away from the combustible cigarettes... to eventually get to full cessation.” This approach aims to provide alternatives that mitigate the most harmful aspects of tobacco use while supporting individuals in their journey to quit.

The Hill

Chelsey Simoni, co-founder and Chief Health Officer of the HunterSeven Foundation, highlighted the confusion surrounding tobacco and nicotine among veterans and service members. She pointed out that many do not understand the distinction between nicotine, which is addictive, and tobacco, which is carcinogenic. Simoni shared her personal experience in trying to help her husband transition from smoking to vaping, illustrating the challenges faced by individuals seeking to quit.

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Simoni remarked, “Cigarettes were on the shelves, and so was chewing tobacco... One of the biggest things we see is that a lot of veterans and service members, along with providers, don’t understand the difference between tobacco and nicotine.”

The Hill

The discussion around tobacco harm reduction underscores the need for targeted health initiatives within the military to educate service members about the risks associated with tobacco use and the benefits of cessation strategies. As the military continues to address the high rates of tobacco use, the integration of harm reduction methods may play a crucial role in improving the overall health of service members.

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Despite the potential benefits of smokeless nicotine products, there are concerns regarding their accessibility and the ongoing availability of traditional tobacco products. Critics argue that without comprehensive education and support, the transition to smokeless alternatives may not effectively reduce overall tobacco use among service members.

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• “One of the biggest things we see is that a lot of veterans and service members, along with providers, don’t understand the difference between tobacco and nicotine.” — Chelsey Simoni, Co-founder and Chief Health Officer, HunterSeven Foundation

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