摘要：Deployment of young Americans in military engagements places them at increased risk for not only war hazards but also tobacco addiction and disease. Tobacco use diminishes troop health and readiness, and increases medical and training costs. Military tobacco control efforts began in 1986, yet tobacco use remains high. To determine whether and how the tobacco industry targets military personnel in wartime, we analyzed internal industry documents about the Gulf War (1990–1991) and constructed a historical case study. During this conflict, tobacco companies targeted troops with free cigarettes, direct advertising, branded items, ways to communicate with family, and “welcome home” events. Military authorities sometimes restricted this activity, but frequently enabled it; tobacco companies were regarded as benefactors. Considering tobacco use a benefit undermines military health priorities. Stronger policy is needed to reframe tobacco use as incompatible with military ideals. DESPITE DECLINES IN CIVILIAN smoking rates in the United States and tobacco control efforts in the US military, tobacco use prevalence in the military remains high, at 32.2% in 2005. 1 Prevalence decreased between 1980 and 1998 (51.0% to 29.9%) 1 ; however, it has increased since then. 2 The military population of 1.4 million active duty service members skews toward likely smokers: young adults, high-school educated, and African Americans 3 near the typical age of smoking uptake. 4 Recruits are more often established smokers than are those who do not enlist, 5 and despite mandatory abstinence from tobacco use during basic training, subsequent relapse or new uptake is common. 6 The Veterans Health Administration estimates that veterans also have significantly higher rates of smoking than do civilians. 7 Smoking diminishes even short-term troop health and readiness 8 , 9 and increases medical and training costs. 10 , 11 During the first Gulf War (1990–1991), smoking prevalence rose among deployed US Naval personnel 12 and US Air Force women, 13 and US Navy personnel who were already tobacco users increased their use. 12 We mined internal tobacco industry documents to explore how tobacco industry and military activity during this period may have contributed to this increased tobacco use.
