Commentary: Tobacco: The Next Winnable Battle for America’s Armed Forces

Research shows that an astonishing 31 percent of America’s service men and women smoke.

Leaders in public health have said that tobacco is one of America’s “winnable battles,” so we are excited that America’s armed forces will now have powerful tools in their arsenal to combat one of the most lethal products available to consumers: tobacco.

Until 2009, TRICARE (the health care system for the military and their families) was not required to provide smoking cessation benefits to military personnel. In fact, any “stop smoking” programs were specifically excluded from TRICARE coverage. The U.S. Department of Defense (DOD) recently announced plans to implement comprehensive smoking cessation programs for our military.

The final implementation of this rule has been years in the making since Congress first required TRICARE to cover cessation in 2009. In 2011, the DOD issued a proposed rule to carry out this requirement. Under the final rule, TRICARE beneficiaries who are living in the 50 states or the District of Columbia and are not on Medicare are eligible for:
o Access to cessation drugs (including over-the-counter drugs) with no co-pay, available at military treatment facilities or through the TRICARE mail order system;
o Counseling (both individual and group) from a TRICARE authorized provider as well as a 24-7 toll-free quitline; and
o Access to print and online tobacco cessation material.
TRICARE will cover two quit attempts per year, with the option of a third attempt covered with physician justification and pre-authorization.

This is a great development, given that it can take up to 11 attempts before a smoker will quit successfully. In fact, this coverage exceeds what the Affordable Care Act and Medicare currently provide for beneficiaries. (A quit attempt is defined as up to 18 face-to-face counseling sessions over a 120 consecutive day period and/or 120 days of pharmaceutical treatment.)

In addition to these benefits, smokers will be receiving the encouraging support they deserve. Under the new TRICARE rule, all those in the chain of command are expected to provide their support to the program and to any member who wishes to quit smoking. This is important because as it is now, there is a lack of smoke-free policies within various military branches.

Unfortunately, the program currently does not provide access to these services to most military personnel living overseas.

However, the Department of Defense rule does not prohibit services overseas so we encourage DOD to develop the capability to make needed cessation service available to all personnel and their families.

Needless to say, members of the military, their families and their loved ones already endure enormous sacrifices on a daily basis. This expanded cessation coverage is one way to offer the help our military families need to safeguard their lives on the public health front.

David Dobbins,
Chief Operating Officer, Legacy