Landstuhl's ban will apply to all military, civilian and contractor personnel as well as local national employees and patients. Currently, only tobacco use inside the building and within a 50-foot halo around doors and public walkways is off-limits.

"We understand the hardship this lifestyle change can create for some users of tobacco products, but U.S. Army Medical Command is taking the lead to improve the overall health for everyone in the MEDCOM family, as well for those we are honored to serve – our patients," Laterza said in a press release. "As medical providers, every leader and employee should become a part of this health education process by modeling healthy behaviors to everyone around them by reducing or quitting their own tobacco use and supporting others who desire to do the same."

On Feb. 15, Landstuhl Regional Medical Center will become a smoke-free campus.

Photo Credit: Army

Army regulations released in April of last year dictate that all medical campuses should be tobacco-free by May 8. The regulation also says that health care personnel shall not smoke in uniform or during a duty block (i.e. while working or on a break). Several other military medical facilities, stateside and abroad, are in the midst of the same push, such as Lyster Army Health Clinic at Fort Rucker, Alabama. 

In the broader health care industry, smoke and/or tobacco-free rules have become increasingly standard.  In 2009, the state of North Carolina, the home of Fort Bragg and a bedrock of the tobacco industry, became the first to require all hospital campuses be smoke-free. The Nonsmokers Rights Foundation lists more than 3,800 medical facilities in the U.S. that have campus-wide smoking bans.

The Defense Department has set a goal to create tobacco-free installations and workforces by 2020, a goal pursued by the Army since 2012.

A broader push

The banishment of tobacco from health care facilities merely represents the tip of the spear in the Army's and Pentagon's efforts to reduce or eliminate its use. The Army maintains tobacco to be the "leading cause of preventable death," and a detriment to health, fitness and readiness. The Center for Disease Control, meanwhile, says cigarette smoking is responsible for 480,000 deaths in the U.S. per year, and that 16 million live with a smoking related disease, to say nothing of other tobacco product risks, and economic costs of tobacco products that the CDC puts at $300 billion.

But while smoking in general is gradually dipping nationwide among most demographics, soldiers still like it – at least moreso than the general population. The Army notes that a 2011 study indicated about half of service members surveyed used nicotine in some form. About 24 percent used cigarettes (compared to about 20 percent of civilians). It costs big money; one 2009 study said treatment of tobacco-related illness and increased hospitalization/lost work days costs the Defense Department $1.6 billion per year, and while smoking has dipped since then, medical costs have increased.

For these reasons, Senate Defense Appropriations chair Dick Durbin, D-Ill., and Senate Armed Services Committee member Sen. Jack Reed, D-R.I., wrote a letter to Navy Secretary Ray Mebus supporting a ban of tobacco sales on military bases and ships.

But such efforts to kill smoking in the military have met resistance. According to the 2011 survey, more than four in five smokers said they smoke to relieve stress and to relax; few cite peer pressure or fitting into unit culture as a cause. And current and former service members have argued that for a group training to go to war, tobacco use seems a trivial concern.

"We sleep in dirt for this country. We get shot at for this country. But we can't have a cigarette if we want to for this country, because that's unhealthy," Rep. Duncan Hunter, R-Calif., said to Congress as he fought for an amendment into the National Defense Authorization Act of 2015 that prohibits bans on tobacco  in commissaries or prices being pushed above market-level. "If you want to make us all healthy, then let's outlaw war, because war is really dangerous."

Kyle Jahner covers Army Medical Command, soldier uniforms and equipment, Army recruiting and breaking news for Army Times. He can be reached at kjahner@armytimes.com.

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