Air Force recruits given antismoking and tobacco use education during basic military training were 23 percent more likely to have abstained from using tobacco products one year later than recruits who didn't receive the intervention, according to a study published in the April issue of the Journal of Consulting and Clinical Psychology (Vol. 74, No. 2). And recruits who received education about the hazards of smokeless tobacco were 33 percent more likely to have abstained at one year compared with those who didn't, says lead researcher Robert C. Klesges, PhD, a cancer prevention and control researcher at the University of Tennessee Health Science Center and St. Jude Children's Research Hospital. During the study, Klesges worked at the University of Memphis.

The results show the public health promise of even a relatively brief antitobacco intervention aimed at encouraging abstinence among former users, Klesges says.

Smoking and smokeless tobacco use is a significant health problem for the military, he says. A 2002 Department of Defense survey of 12,756 active-duty military personnel found that 33.8 percent of respondents had smoked a cigarette in the past month, an increase from 29.9 percent in 1998. That increase came at a time when smoking among the civilian population decreased from 24.1 percent to 22.5 percent, he says.

Given the fact that recruits can't smoke cigarettes or chew tobacco during basic training, researchers wanted to intervene during a "teachable moment" to see if they could help study participants stay abstinent, he says.

"We wanted to help people who smoked before basic military training to stay quit, to get people who used smokeless tobacco to not resume, and for people who didn't smoke before to not initiate smoking," says Klesges. In the study, 75 percent of recruits received an antismoking intervention tailored to whether they had never smoked, occasionally smoked, regularly smoked or were a smokeless tobacco user. The remaining 25 percent received a general health-promotion message. The presentation was about two hours for smokers and nonsmokers and three hours for smokeless tobacco users and emphasized reasons to stay away from tobacco once basic training was complete. For example, the program explained that a pack-a-day habit adds up to one month's salary for a junior airman and that smoking impairs performance on the service's physical readiness test, a factor in promotion.

One year after basic military training, the airmen were contacted for a follow-up survey by telephone or questionnaire. Although the educational intervention appeared to positively influence abstinence among airmen who had regularly smoked or used smokeless tobacco before, it did not appear to have an impact on preventing those who hadn't smoked before joining the military from starting, Klesges says.

In both the study group and control group, about 10 percent of "never smokers" were smoking regularly at one year, and about 29 percent of airmen who had tried cigarettes once before enlisting were smoking, Klesges says.

Further studies will explore why recruits who have never smoked take up tobacco once they're in the military and how to improve overall abstinence rates among prior tobacco users, he says.

-C. Munsey