Addressing Combat Stress and Tobacco: An Innovative Approach for State Quitlines

Military service members have a higher tobacco use rate than members of the general public. Post-traumatic stress disorder (or combat stress as it is called in military communities), plays a major role in service member tobacco use as well as in the lives of those within military communities. The relationship between disproportionate tobacco use, severity and effects of combat stress, and the longstanding, unique culture of this population necessitates a culturally appropriate approach by public health professionals in creating tobacco cessation resources, developing programs, and initiating branch-specific efforts to provide services to members of the military. The distinct public health challenges of military communities are the focus of the partnership between the California Smokers' Helpline and Project UNIFORM. This unique collaboration works directly with quitline counselors to ensure their firm understanding of how combat stress affects tobacco use. This understanding, combined with cultural awareness trainings, allows counselors to utilize appropriate interventions with service members who contact the state-sponsored, telephone-based tobacco cessation program. While the collaboration that exists between the two programs is unique, it could be easily duplicated by other states and communities.