期刊论文详细信息
BMC Public Health
“Throwing a rock at their armored tank”: civilian authority and military tobacco control
Ruth E Malone1  Elizabeth A Smith1  Quinn Grundy1 
[1] Department of Social and Behavioral Sciences, University of California, San Francisco, 3333 California St, San Francisco, CA 94118, USA
关键词: Civilian;    Policy;    Public health;    Military;    Tobacco control;   
Others  :  1092032
DOI  :  10.1186/1471-2458-14-1292
 received in 2014-09-30, accepted in 2014-12-15,  发布年份 2014
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【 摘 要 】

Background

Tobacco use is a major cause of chronic disease, disability and death among military personnel and veterans. However, civilian public health and tobacco control advocates have been relatively silent on the issue. Research on the tobacco industry shows a long history of interference in military tobacco policy through relationships with the United States (US) Congress. The military cannot autonomously implement tobacco control, but is subject to Congressional oversight. Thus, the primary obstacles to effective tobacco control in the military are Congressional political opposition and tobacco industry influence, and by extension, a lack of civilian awareness and support in the policy arena.

Methods

As part of a larger project to explore the topic of civilian support for military tobacco control, we analyzed data from focus groups with public health professionals to better understand their sense of agency and authority in regards to military tobacco control. Researchers conducted 4 focus groups with a total of 36 public health professionals at key conferences for those working in public health and tobacco control. Data were coded and the research team developed an interpretive account that captured patterns and variations in the data.

Results

Public health and tobacco control participants shared a sense of futility regarding civilian efforts to engage in military tobacco control. This stemmed from feeling ignorant of military culture and structure, identifying powerful discourses that opposed tobacco control, particularly in a military context, and the very-real presence of the tobacco industry lobby throughout the policy process.

Conclusions

A strong public health voice on military tobacco control might serve to begin problematizing the tobacco industry’s influence in the military policy arena. As the military moves to institute stronger tobacco control policy, public health and tobacco control professionals should work to engage with and aid its efforts from the outside. Only with such civilian side support can the goal of a tobacco free military be realized.

【 授权许可】

   
2014 Grundy et al.; licensee BioMed Central.

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【 参考文献 】
  • [1]Memorandum: Reducing tobacco use in the armed forces and the Department of Defense. http://s3.documentcloud.org/documents/1165289/reducing-tobacco-use-in-the-armed-forces-and-dod.pdf webcite]
  • [2]Institute of Medicine: Combating Tobacco Use in Military and Veteran Populations. Washington, DC: The National Academies Press; 2009.
  • [3]Smith EA, Jahnke SA, Poston WSC, Williams LN, Haddock CK, Schroeder SA, Malone RE: Is it time for a tobacco-free military? N Engl J Med 2014, 371:589-591.
  • [4]Lando HA, Michaud ME, Poston WSC, Jahnke SA, Williams L, Haddock CK: Banning cigarette smoking on US Navy submarines: a case study. Tobacco Control 2014. doi:10.1136/tobaccocontrol-2014-051624
  • [5]Kramarow EA, Pastor PN: Current smoking among men aged 25-64 years, by age group and veteran status. Morb Mortal Wkly Rep 2012, 61:929.
  • [6]Department of Defense: DoD Survey of Health Related Behaviors Among Active Duty Personnel. Washington, D.C.: Department of Defense; 2013.
  • [7]Smith EA, Malone RE: Military exceptionalism or tobacco exceptionalism: how civilian health leaders’ beliefs may impede military tobacco control efforts. Am J Public Health 2013, 103:599-604.
  • [8]Halvorson A: Understanding the Military. Rockville: Substance Abuse and Mental Health Services Administration; 2010.
  • [9]Smith EA, Grundy Q, Malone RE: “It‘s not a priority when we’re in combat”: public health professionals and military tobacco control policy. Am J Public Health 2014. in press
  • [10]Smith EA, Malone RE: Mediatory myths in the U.S. Military: tobacco use as “Stress Relief. Am J Health Promot 2014, 29:115-122.
  • [11]Jahnke SA, Haddock CK, Poston WSC, Hoffman KM, Hughey J, Lando HA: A qualitative analysis of the tobacco control climate in the U.S. military. Nicotine Tob Res 2010, 12:88-95.
  • [12]Poston WSC, Suminski RR, Hoffman KM, Jitnarin N, Hughey J, Lando HA, Winsby A, Haddock K: Military line leadership and tobacco control: perspectives of military policy leaders and tobacco control managers. Mil Med 2010, 175:811-816.
  • [13]Stein RJ, Pyle SA, Haddock CK, Poston WSC, Bray R, Williams J: Reported stress and its relationship to tobacco use among U.S. military personnel. Mil Med 2008, 173:271-277.
  • [14]Letter to Secretary Mabus [http://www.stripes.com/polopoly_fs/1.275251.1396115497!/menu/standard/file/Hunter_Mabus_tobacco.pdf webcite]
  • [15]Steele J: More on Navy cigarette sales. 2014. http://www.utsandiego.com/news/2014/apr/01/hagel-hunter-navy-cigarette-sales-ships-bases/ webcite
  • [16]Harper J: Lawmakers to Navy: keep selling cigarettes. Stars and Stripes 2014. http://www.stripes.com/news/lawmakers-to-navy-keep-selling-cigarettes-1.276248 webcite
  • [17]Mechanic M: Is the world’s most powerful military defenseless against Big Tobacco? Mother Jones 2014. http://www.motherjones.com/politics/2014/05/military-tobacco-cigarette-sales-navy-congress webcite
  • [18]House passes $585B defense bill [http://thehill.com/blogs/floor-action/house/226039-house-passes-2015-defense-authorization webcite]
  • [19]Smith EA, Blackman VS, Malone RE: Death at a discount: how the tobacco industry thwarted tobacco control policies in US military commissaries. Tob Control 2007, 16:38-46.
  • [20]Arvey SR, Malone RE: Advance and retreat: tobacco control policy in the U.S. Military. Mil Med 2008, 173:985.
  • [21]Krueger RA: Moderating Focus Groups. Thousand Oaks: Sage Publications; 1998.
  • [22]Morgan D: Focus Groups as Qualitative Research. 2nd edition. Thousand Oaks: Sage Publications; 1997.
  • [23]QSR International Pty Ltd: NVivo qualitative data analysis software. 2012.
  • [24]Smith EA, Malone RE: ‘We will speak as the smoker’: the tobacco industry“s smokers” rights groups. Eur J Public Health 2007, 17:306-313.
  • [25]Offen N, Smith EA, Malone RE: “They‘re Going to Die Anyway”: smoking shelters at veterans’ facilities. Am J Public Health 2013, 103:604-612.
  • [26]American Public Health Association: National Public Health Week — Public Health Is ROI. Washington DC: American Public Health Association; 2013.
  • [27]Department of Defense press briefing by Secretary Hagel in the Pentagon Briefing Room [http://www.defense.gov/Transcripts/Transcript.aspx?TranscriptID=5399 webcite]
  • [28]Luke DA, Krauss M: Where there“s smoke there”s money: tobacco industry campaign contributions and U.S. Congressional voting. Am J Prev Med 2004, 27:363-372.
  • [29]Smith EA, Malone RE: Tobacco promotion to military personnel: “The Plums Are Here to Be Plucked.”. Mil Med 2009, 174:797.
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