MILITARY TOBACCO USE: OVERVIEW OF USE AND OPPORTUNITIES TO PROVIDE TOBACCO CESSATION TO STUDENT VETERANS. Session Two

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Magdalene Peters
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1 MILITARY TOBACCO USE: OVERVIEW OF USE AND OPPORTUNITIES TO PROVIDE TOBACCO CESSATION TO STUDENT VETERANS Session Two 1

2 SESSION TWO: MILITARY TOBACCO USE Military Tobacco Use Smoking Smokeless Tobacco Use Veteran Tobacco Use Why Veterans smoke Student Veteran tobacco use Reaching Student Veterans Barriers for Student Veterans in utilizing on-campus services Obstacles in reaching Student Veterans Opportunities to provide tobacco cessation to Student Veterans 2

3 MILITARY COMMUNITY TOBACCO USE Percentage of military personnel, gender, and Service, who reported any nicotine use in the past 12 months. Female Male 27.7% 43.6% 31.6% 54.4% 31.8% 52.6% 40.3% 62.4% 31.4% 54.4% Air Force Army Coast Guard Marine Corps Navy 3

4 MILITARY COMMUNITY SMOKING 4

5 MILITARY COMMUNITY SMOKELESS USE Air Force 13.3% Civilian Adults 3.6% (male adults 7.1%) Army 20.8% Coast Guard 19.6% Marine Corps 31.9% Navy 16.9% 5

6 SMOKELESS USE BY GENDER & AGE* Air Force Army Coast Guard Marine Corps Navy Males Females yrs old yrs old *Defined as those who have used chewing tobacco, snuff, or other smokeless tobacco in the past 12 months. 6

7 MILITARY COMMUNITY TOBACCO USE Of the current Service Members who smoke, 36-40% started after joining the military. The top reasons Service Members give for smoking: Helps me relieve stress I smoke when I drink alcohol Helps me relieve boredom Helps keep me awake or alert Helps me relax or calm down What would cause Service Members to smoke less? A significant decrease in the number of places at the installation where smoking or using tobacco is permitted. Prices on the installation were increased to match prices outside the installation. 7

8 MILITARY COMMUNIT Y TOBACCO USE The lower the pay grade, the higher the tobacco use. Over one-fifth (22.6%) of all Service Members have smoked cigars in the past 12 months. 44% of heavy smokers also used smokeless tobacco in the past 12 months. 29% of former smokers have used smokeless tobacco in the past 12 months. 8

9 MILITARY COMMUNITY TOBACCO USE Military retail outlets continue to sell tobacco at deep discounts. Only 4.9% of military retailers in 2013 were in compliance with the 5% rule. 5% rule = DoD mandates tobacco at bases be sold for no less than 5% below the lowest local price. Some brands were priced 73% lower than local Walmart stores. Cigarettes were found as cheap as $1.97 per pack on a military installation vs. $7.29 per pack at the local Walmart. 9

10 VETERAN TOBACCO USE Male veterans aged years were more likely to be current smokers than nonveterans (29% versus 24%). Among men aged years, 36% of veterans reported being current smokers, compared with 24% of nonveterans. Lifetime cigarette smoking was higher among rural veterans (67.4%) than those living in urban (60.3%) or suburban areas (60.3%). 10

11 WHY DO VETERANS SMOKE? Some started using tobacco during deployments to: Stay awake Have something to do during down times Improve job performance Manage stress Acceptable way to take a break Make social connections and get information A way to mark a passing, We d know one of the guys didn t come back and we d all sit there and smoke and nobody would say a word.

12 WHY DO VETERANS SMOKE? Once Service Members returned stateside many continued to use tobacco to: Regulate mood Manage with stress Cope with post-deployment life Manage injuries Relieve sleep disorders Help with mental health issues Addiction

13 STUDENT VETERAN TOBACCO USE Student Veterans who served in Afghanistan or Iraq enrolled are more likely than other college students to use tobacco products, binge drink and be involved in physical fights More OEF/OIF Student Veterans said they were currently cigarette smokers or had recently used smokeless tobacco, compared with non-veteran students More OEF/OIF veterans planned to quit before graduation than nonveterans. 13

14 REACHING STUDENT VETERANS : OBSTACLES AND OPPORTUNITIES 14

15 WHY FOCUS ON STUDENT VETERANS People who have volunteered for our country Higher rates of risky health behaviors (e.g., tobacco and alcohol use) May be unaware of available services If denied services by one provider (e.g., VA), may not think they are able to seek care from another provider Great group to work with and incorporate into other areas as well 15

16 BARRIERS FOR UTILIZING SERVICES Do not feel services would benefit them Do not want to talk about past experiences Not aware of programs and services offered Do not know where services are 16

17 ASSESSMENTS: OVERVIEW Two focus groups conducted in October 2014 in Northern and Southern California Online assessment conducted in October 2014 and distributed to community colleges in North Carolina Participants included administrators from student affairs offices, staff from student veteran centers, student health center directors, nurses, and health educators Discussion focused on: current tobacco cessation services provided on campus knowledge of student veterans work with Veteran Centers current health-related services provided to student veterans barriers/challenges providing services to student veterans 17

18 FINDINGS: CHALLENGES REACHING STUDENT VETERANS Don t know who is a veteran No intake questions about military service Only know if someone discloses their service history Access to services Commuter students may not be interested in on-campus services Veterans may not want to come to health center because they don t fit the services provided Health condition may not be a priority (e.g., quitting smoking) 18

19 FINDINGS: CHALLENGES REACHING STUDENT VETERANS Veterans Centers Campus does not have a Student Veterans Center Veterans Center may have limited staff and no time to promote other services Distrust of other services provided to student veterans (are they culturally appropriate?) Veterans Center offers mental health services to student veterans and does not refer out for other services 19

20 FINDINGS: OPPORTUNITIES TO REACH STUDENT VETERANS How to access this group Take it slowly Go to the Student Veterans (do NOT expect them to come to you!) Be respectful Be authentic Build a relationship with whomever works at the Vet Center (if you have one) If there isn t a Vet Center on your campus, consider other avenues (VSOs, student groups, etc.) 20

21 MESSAGES: WHY DO VETERANS WANT TO QUIT? Health Break dependency on tobacco Side effects of tobacco Teeth, hands, breath, smell Family Children very important Serve as an example Personal experience of losing a loved one Cost Social norms

22 STRATEGIES TO INCREASE PARTICIPATION Get Student Veterans involved directly Champions Leadership positions Outreach to Veterans AND family members Health fairs Community events (off-campus) Collaborate with Military Treatment Facilities near your campus 22

23 STRATEGIES TO INCREASE PARTICIPATION Think outside of the box How can you access Student Veterans differently? Do you have the resources to offer support differently? How can you meet Student Veterans where they are at? Consider all/non-traditional partners Who has access to Student Veterans? Professors/ Instructors Can tobacco information be incorporated into other teachable moments? Nutrition, weight management, athletics, mental health, etc. Get administration and other decision makers (including student government) support A champion can go a long way to success 23

24 CASE STUDY: PASADENA CITY COLLEGE Located in Pasadena, CA 100% smoke/tobacco-free college Student Health Services offers individualized quit smoking program for students 8 session program $15 refundable fee **If all sessions completed 24

25 CASE STUDY: PASADENA CITY COLLEGE 1 Orientation 2 Preparation for Quit Day 3 Quit Day 4 Motivation and Coping Skills 5 Lifestyle Issues 6 Stress Management Skills 7 Managing Urges 8 Completion of the Program and Certificate of Achievement 25

26 CASE STUDY: PASADENA CITY COLLEGE Nurse from Health Center visits the Veterans Resource Center every week (same day of the week, every week) Started slow, was respectful, friendly, approachable Now Student Veterans approach her for tobacco cessation assistance AND many, many other issues Have told her (and us) that they feel more comfortable going to the Health Center because they know her and trust her Told us. It s important to, Be real. Veterans can tell a fake person from far away. Be consistent with visiting the Veterans Resource Center, even when you think no one will show up, people notice when you are there and not there. 26

27 CONTACT CYAN/PROJECT UNIFORM For additional information or support with working with military communities and Student Veterans on tobacco-related issues, please contact CYAN/Project UNIFORM at or (916) x

Exploring Military & Civilian Tobacco Control Partnerships

Exploring Military & Civilian Tobacco Control Partnerships Colleen Haydon Project UNIFORM/CYAN Living Well: Strategies for Tobacco Free Recovery 6 March 2012 What is Project UNIFORM? Undoing Nicotine Influence