Military smoking regulations and ethical military responsibility

Military Ethics -- Smoking

Within the last half century, the habit of tobacco smoking has undergone a tremendous change in terms of its perception in American society. In the middle of the 20th century, more than half of all American adults smoked cigarettes; smoking products were advertised on television and as frequently as not they were associated with images of health, youthfulness, and vitality in advertising campaigns. The medical community first began to warn of the probable medical consequences of smoking in the early 1960s, but the tobacco industry invested billions of dollars in countering those messages in connection with its public campaign to reassure the public that there was no credible evidence that smoking presented no personal health.

There were no public acknowledgements by the tobacco industry that smoking was indeed empirically connected to human disease (and to cancer in particular) until individual whistleblowers within the industry began to come forward publicly in the early 1990s. The resulting class action law suits pursued by the attorneys general of individual states imposed substantial civil awards and brought tighter industry restrictions and disclosure requirements. Today, there is no longer any dispute with regard to the dangers of smoking; in fact, smoking is known to be the single greatest avoidable risk to human health and longevity, dwarfing the combination of many other specific risks such as drug abuse, criminal violence, and drunk driving.

Whereas the United States armed services generally impose much stricter regulations of conduct on enlisted personnel than those applicable to ordinary civilians, it has so far omitted a formal recognition of the magnitude of the harm (and financial costs) caused by military personnel smoking. Meanwhile, even civilian society is becoming less and less permissive about smoking, particularly in public, precisely in recognition of the dangers associated with smoking. To be more consistent, as well as because it furthers very important interests of the U.S. military (and in several different ways, those of the civilian public on whose behalf they serve), the U.S. Military Code of Justice should revise its provisions to include an appropriate approach to smoking by enlisted personnel. Doing so would benefit military personnel personally, as well as improve their ability to fulfill their responsibilities, and it would also result in substantial cost savings to the federal budget.

Applicable Principles of Military Authority

In general, enlisted military personnel give up various rights of civilians during their period of enlistment. More particularly, the U.S. Uniform Code of Military Justice (USUCMJ, 2009) even goes so far as to address and impose punishment for soldiers who allow themselves to sustain sunburns unnecessarily. The rationale is very logical and simple: sunburns can interfere with a soldier's ability to perform his or her official duties; in the extreme, they can be incapacitating and require acute medical attention. Since the ability to avoid sunburns is usually within the soldier's ability to avoid by exercising ordinary prudence and self-care, the failure to do so is punishable under the U.S. Uniform Code of Military Justice when it results in a sunburn (USUCMJ, 2009).

In many important respects, smoking is more damaging to the health of enlisted personnel and (potentially) to their ability to fulfill their missions at the highest level of performance of which they are capable. Smoking is associated with increased incidence of colds, respiratory distress, and allergy susceptibility (Reid, 2009). Smokers score lower on virtually all standard measures of human health and physical well-being, and they suffer tremendously increased risks of many of the most serious diseases that cause premature physical deterioration and death. More particularly with respect to military service, a tremendous amount of military training relates directly to physical conditioning, a very large aspect of which is cardiovascular and aerobic conditioning. In that regard, permitting smoking among enlisted personnel seems anathema to some of the most basic and fundamental requirements of optimal military service and individual preparedness.

Prohibiting smoking among enlisted personnel would be more appropriate with respect to the legitimate concerns of their health and physical fitness for duty. It would also better satisfy the purpose and intent of the Uniform Code of Military Justice. Finally, it would be much more consistent with other existing UCMJ provisions addressing risks to the physical health and well-being of enlisted personnel that are almost inconsequential in comparison to the detrimental effects and health concerns associated with smoking.

The Relative Harms Associated with Smoking

Even before the historic admission by tobacco industry whistleblowers that all of the tobacco companies were fully aware of the serious health risks of smoking, the modern medical community had established that smoking accounts for more human disease, disability, and premature death than all forms of violent crime, vehicular accidents (including drunk driving), all forms of illicit drug abuse, alcoholism, HIV / AIDS, and all forms of non-smoking-related cancers, combined (Reid, 2009). In fact, approximately 1,000 Americans die every day as a result of smoking (Dershowitz, 2002; Repace, 2004).

Even where smoking does not result in fatal disease, the financial costs associated with treating the myriad symptoms and less serious chronic and short-term disease correspond to billions and are the greatest single unnecessary cause of medical expenditures in the U.S. healthcare system (Reid, 2009). Furthermore, cigarette smoke is so toxic that it even causes health problems in non-smokers who are regularly exposed to second-hand smoke. That is especially problematic with regard to children of smokers since volumes of empirical evidence have established the greater incidence of various specific diseases (especially those of the respiratory functions) among children in homes where one or more adults smoke cigarettes (Reid, 2009).

As a result, several states have already enacted statutes prohibiting smoking in motor vehicles carrying minor children (O'Neill & Lite, 2008). Similarly, smoking has been banned on all American airline travel and public transportation, and smoke-free workplace environments and restaurants are increasingly becoming the norm within American society, precisely in recognition of the magnitude of the health risks of second-hand smoke. Several states have banned smoking in any public business and even outside in public parks and on other municipal property and more and more private property owners and landlords are including no-smoking clauses in their residential and commercial leases (O'Neill & Lite, 2008).

Meanwhile, smoking rates among military personnel are substantially higher than among the general (i.e. civilian) population. This may be due in large part to the demographic factors reflected in those who sign up for military service as well as the nature of some aspects of military service, such as the boredom associated with many types of deployments and missions. It may also be a function of the stimulant effect of caffeine that also accounts for high consumption of coffee in the military. The problem is that smoking inevitably reduces the individual's capacity for aerobic conditioning and physical endurance; it also increases absenteeism and the costs borne by the taxpayers for treating the symptoms associated with unnecessary illness and disease among enlisted personnel caused directly and indirectly by smoking.

Conclusions

American society once embraced smoking as a social pastime, even associating it with images of health and youthful vitality. More recently, the medical community began publicizing the tremendous dangers associated with smoking. In addition to directly causing more human disease and premature death than virtually all other major health risks combined, smoking exacts an unacceptable toll on the American healthcare system. As bad as that is in civilian society, it is even more inconsistent with the duties and responsibilities of military service. Military personnel must achieve and maintain the best physical conditioning of they are reasonably able to reach for the duration of their enlistment as a fundamental obligation of being fit for duty. Smoking makes that impossible. Likewise, the American taxpayer has a justifiable interest in reducing the costs of fielding a military by eliminating unnecessary costs. Smoking invariably adds to the already substantial costs of providing medical care to armed services personnel, both during their active service as well as throughout their lives afterwards to the extent they rely on veteran's services for medical care.

Military personnel already understand that the privilege and benefits associated with military service entail various restrictions on rights enjoyed by civilians. In this case, military justice must catch up to the manner in which civilian society has already incorporated the understanding of the risks of smoking into American life.