Establishment and evaluation of a smoking cessation programme on the prevalence and intensity of smoking during a 6-month military deployment.

Abstract

Introduction: Military personnel smoke more frequently and intensely than civilians, with deployments often destabilising smoking behaviours and influencing long-term tobacco use. This study evaluated smoking prevalence and intensity at the start and end of a deployment among personnel with access to a smoking cessation service, identifying factors affecting cessation using the capability, opportunity, motivation, behaviour (COM-B) model.

Methods: During a 6-month deployment (January-June 2019), a smoking cessation programme was established and evaluated through a prospective longitudinal service evaluation. Two British Army medical officers, certified by the National Centre for Smoking Cessation and Training, delivered the programme to approximately 120 UK Armed Forces personnel. At both the start and end of the deployment, participants voluntarily and anonymously completed a questionnaire recording age, rank, sex, smoking status and smoking intensity.

Results: Surveys were completed by 112 (95%) personnel at the start and 87 (77.7%) at the end. Initially, 44 personnel (39.3%) identified as smokers, compared with 38 (43.7%) at the end. The relative risk of smoking at the end versus the 2019 British Army trained strength was 1.9 (95% CI 1.5 to 2.41; p<0.0001). Smoking prevalence was higher among men and other ranks, with 44.6% of junior and 63.6% of senior other ranks smoking by the tour's end. Median daily cigarette consumption increased, though not significantly. Provider-level factors in the COM-B model were the primary facilitators, while system-level factors were the main barriers to smoking cessation.

Conclusions: This is a novel prospective evaluation of a smoking cessation programme in the context of a deployed military setting. It contributes to the existing literature by detailing the unique barriers and facilitators that can influence smoking behaviours in such settings, as well as identifying leverage points for intervention. The findings highlight the importance of tailored smoking cessation interventions that account for the unique challenges and opportunities present during military deployments.