Effect of an eight week smoking ban on women at US Navy recruit training command

Abstract

Objective-To examine the eVect of a unique organisational smoking ban on female United States Navy recruits, a population with historically high smoking rates. Setting and design-Study participants were female recruits (n = 5503) entering the Navy recruit training command between March 1996 and March 1997 (12 consecutive months). Participants completed smoking surveys at entry to recruit training (baseline) and again at graduation from training after exposure to an eight week, 24 hour a day smoking ban. EVects of the ban on baseline to graduation changes in perceptions of being a smoker were examined, and relapse rates among baseline ever smokers was assessed three months after leaving recruit training. Results-Among all recruits, 41.4% reported being smokers at entry (that is, reported any smoking in the 30 days before entering recruit training). As a result of the ban, there was a significant reduction (from about 41% to 25%, p < 0.001) in the percentage of all women recruits who reported themselves as smokers, a much larger change than expected had no ban been in place. Relapse at the three month follow up varied according to the type of smoker at entry into the Navy, with rates ranging from 89% relapse among baseline daily smokers to 31% among baseline experimenters. Conclusions-Findings suggest that the ban provides some smokers who desire to quit with an external impetus and support to do so. However, high relapse rates indicate that more than an organisationally mandated smoking ban during recruit training is needed to help younger smokers, more regular smokers, and those who intend to continue smoking to quit after joining the Navy.

Equity impact of interventions and policies to reduce smoking in youth: systematic review

“…A 24 h 8-week workplace smoking ban in female US Navy volunteers reduced the proportion of women smoking immediately post-ban, but most had relapsed by 3-month follow-up 30. Educational level did not significantly predict smoking relapse (neutral equity impact); however, loss to follow-up was high and non-respondents were more likely to be smoking.…”

“…Twelve studies21 – 23 30 36 38–40 50 – 52 58 examined the equity impact of smoking restrictions in public places: 11 cross-sectional studies and 1 intervention study. Six studies assessed comprehensive national/state smokefree legislation, and six studies assessed policies that were voluntary, including one intervention study that assessed a worksite total smoking ban enforced for 8 weeks military training 30…”

“…The equity impact of voluntary smokefree policies was: four neutral,30 38 39 58 one negative36 and one mixed (neutral and negative) 40. Three of these studies investigated smoking behaviour in cars with children, in the context of no smokefree vehicle legislation (one negative equity impact and two neutral for equity impact) 38 52 58.…”

Military tobacco use: A synthesis of the literature on prevalence, factors related to use, and cessation interventions

“…All military service branches implement a forced tobacco abstention in their recruits during their initial BMT. Although this may be perceived as a way to initiate tobacco cessation (Conway et al, 2004;Klesges et al, 2006;Woodruff, Conway, & Edwards, 2000), studies have demonstrated that forced abstinence without additional interventions does not result in sustained abstinence. Woodruff et al (2000) demonstrated that 89% of women were abstinent 3 months following Navy BMT; however, other studies found high rates of recidivism in male and female recruits post-BMT with 68% to 84% (Williams, Hermesch, Gackstetter, Lando, & Fiedler, 1996) of the recruits who completed BMT returning to tobacco use within the first month.…”

“…Although this may be perceived as a way to initiate tobacco cessation (Conway et al, 2004;Klesges et al, 2006;Woodruff, Conway, & Edwards, 2000), studies have demonstrated that forced abstinence without additional interventions does not result in sustained abstinence. Woodruff et al (2000) demonstrated that 89% of women were abstinent 3 months following Navy BMT; however, other studies found high rates of recidivism in male and female recruits post-BMT with 68% to 84% (Williams, Hermesch, Gackstetter, Lando, & Fiedler, 1996) of the recruits who completed BMT returning to tobacco use within the first month. Conway and colleagues (2004) used two relapse prevention interventions in addition to standard treatment to examine the rate of recidivism among 2,781 female Navy recruits after a forced tobacco ban during BMT with the following interventions: (a) standard treatment, (b) standard treatment plus serial monthly mailings to support relapse prevention, and (c) standard treatment plus access to a toll-free telephone help line to support relapse prevention.…”