There's a lot of hype regarding tobacco these days; it's difficult to walk down the street or sit in five o'clock traffic without seeing someone take a drag of a cigarette or become immersed in the cloud-like puffs of smoke from electronic cigarettes. Although we now know more than ever before about tobacco and its effects on those who use the products associated with it, use is still bigger than it should be - among civilians and members of the Armed Forces alike. Dr. Ari Gilmore is a family medicine physician who has been working with PacMed for roughly nine years, and has an extensive knowledge of tobacco and the negative consequences associated with its use.

What is the current research suggesting regarding tobacco use and its correlation military members?

It's really similar to the civilian population: it costs a lot in terms of loss of productivity and long-term healthcare expense. I don't think there are significantly greater risks for someone who is in the military and is smoking versus someone who isn't, but certainly - when you're in a field that for many people requires a certain level of physical fitness, and you add loss of productivity to that, people have difficulty passing tests and exams that are essential to their job duties.

What are some of the more popular tobacco products and what are the negative consequences associated with using them? (Cigarettes, chew, etc.)

I think a lot of people don't realize that chewing tobacco is highly correlated to mouth and throat cancer, and that it also causes high blood pressure. People also fail to realize the affect that cigarettes have on the lungs and overall health in general.

Would you say that there is a link between tobacco use and performance for military members?

There are higher rates of bronchitis, there are the healthcare costs that have to be considered because people are getting sicker due to heart attacks, high blood pressure and lung cancer - 1.6 billion dollars annually is being spent on healthcare costs and productivity loss combined because of these issues, and that number is projected to grow to roughly 19 billion by the year 2025.

Costs of tobacco products are rising - why do you believe this is? What impact will higher costs for these products have on those that use them and on the industry in general?

I've noticed that the DoD is working to increase the costs of tobacco products in the military-based stores where there are normally large discounts. This is a specific tool to decrease use among military members, as there is good evidence that suggests higher costs does decrease use. This fact has been proven in the civilian world, and there is hope it would have the same effect in the military community as well.

What new regulations have been made by the Food and Drug Administration (FDA) in regards to tobacco products and their use?

The industry that is making and promoting the vaporizing technology has fought pretty hard to label their products "smoke cessation" products, which allows them to not be regulated by the FDA. There are a whole host of ways the FDA will regulate the vaporizing products, from the temperature at which it vaporizes, the batteries that power the machines, to the containers themselves to make sure they aren't broken as easily. There have been incidents of child poisonings in which the containers have broken and kids can absorb nicotine straight from the liquid - which can be fatal.

There has been a rise in popularity for the e-cigarette trend. Is this option a safer one for those who are choosing this alternative over traditional tobacco products? Why do you believe it has become so fashionable?

Yes - but the answer is kind of a hedge. For a regular, moderate smoker, transitioning to a vaporizer is going to have less negative health consequences. I think there are several reasons (for its popularity): for one, it's easy. It doesn't smell, so someone can use it just minutes before walking back into their job and people around them won't smell it, which is an appeal in customer-service work. The vaporizing industry has worked hard to get products placements - Bruno Mars is often seen with an e-cigarette. It kind of looks "cool" because it has these big puffs of smoke that come out when you use it, and often times it's a little less expensive. A lot of these e-cigarettes are made to look really interesting with their LED lights and customization options, which interests people.  

Is there anything else you would like readers to know about tobacco and its use and/or effects in relation to our Armed Forces?

Yes, I think the number one thing to remember regarding the vaporizers is that there is nicotine in them, and that is a very powerful substance. Even though it looks like a toy, people end up not being able to put the toy down. There is still a significant risk of addiction associated with these products, and there are a lot of negative consequences that occur when using them.