Addictions Counseling Today by Kevin G. Alderson

Author:Kevin G. Alderson
Language: eng
Format: epub
Published: 2019-11-29T20:23:26.181217+00:00

War Veterans

Because individuals with PTSD and other mental disorders have high rates of smoking and low quit rates, it is not surprising that these rates carry over to veterans as well. Nicotine shares the spotlight with alcohol as the most common substances of abuse among veterans (Moore, 2012). Approximately 22.7 million American veterans and their family members are in danger of tobacco-related health problems (Ogbonna, 2018).

During the Gulf War (1990–1991), troops were directly targeted by tobacco companies with free cigarettes, branded items, ways to communicate with family, and “welcome home” events (Smith & Malone, 2009). Authorities often perceived the companies as benefactors and enabled them despite military tobacco control efforts beginning in 1986.

Among veterans participating in a smoking cessation treatment study, three factors were found by Travaglini, Li, Brown, and Bennett (2017) to predict greater treatment engagement: (a) those who had never been married, (b) previous attendance in a smoking cessation group, and (c) more severe symptoms as measured by the Brief Psychiatric Rating Scale. Interestingly, the study by Scherrer et al. (2008) of 6099 members of the Vietnam Era Twin Registry found that combat exposure was associated with lifetime nicotine dependence only through genetic/environmental factors related to PTSD.

The Veterans Health Administration (VHA) requires specialty care settings to screen for tobacco use and offer smoking cessation treatment (Gifford, Tavakoli, Wisdom, & Hamlett-Berry, 2015). However, there are still critical gaps in the provision of smoking cessation treatment in these settings. One study of 137 veterans enrolled in an SUD treatment program as well as a tobacco cessation education program found that only 14.4% of 1-month follow-up respondents reported abstinence from tobacco (Vest et al., 2014). Vander Weg et al. (2017) studied 898 adult veteran smokers attending four VHA programs for tobacco addiction and found similarly disappointing results. Vander Weg et al. recommended that VHA programs need to alter clinician behavior and enhance postdischarge follow-up. Another potential treatment option is home telehealth and motivational interviewing (MI), which veterans appear open to trying (Peterson, Battaglia, Fehling, Williams, & Lambert-Kerzner, 2017).

Veterans living with HIV (PLHIV) have a high rate of smoking. Using data from a national random sample of veterans, smoking prevalence was estimated from self-report of both smoking status and HIV. Results revealed that 42% of PLHIV smoked daily, compared to 18% of veterans without HIV and 30% of nonveterans living with HIV (Wilson, Pacek, Dennis, Bastian, Beckham, & Calhoun, 2017).

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