Tobacco use among military personnel is a serious and ongoing issue. The latest study estimates that 13.9 percent of them smoke cigarettes. While this figure is slightly lower than civilian rates, it conceals huge disparities. Air Force officers have tobacco use prevalence rates in the low single digits, while enlisted Marines and soldiers use tobacco at rates far outstripping their civilian counterparts. For example, among young service members, 19.5 percent are current smokers, while 13 percent of civilian youth smoke. In that same group, 18.4 percent of use smokeless tobacco, while only about 7 percent of civilians do. The connection between military service and tobacco use is culturally taken for granted and reinforced by movies and television shows as well as real life examples. A widely reprinted 2004 front-page photograph in the New York Post showed Marine James Blake Miller smoking a cigarette and the headline, "Smokin': Marlboro men kick butt in Fallujah."[1]

In Smoke 'Em If You Got 'Em, historian Joel Bius (US Air Command and Staff College) explores just how the cigarette became so entrenched in military life, with specific attention to the cigarette rations issued to Army members from World War I to 1973. The book's two parts comprise ten chapters. Part I, "The Rise" focuses on the creation of the cigarette ration, beginning with the Army's often contentious relationship with the YMCA, which it had tasked with morale, welfare, and canteen activities, including distribution of cigarettes (despite the Y's opposition to smoking). By the end of the First World War, the relationship had soured, and a new Army Chief of Staff set out to militarize these activities. A chapter on the cigarette ration during World War II, including a parallel rise in smoking by civilians, closes this section.

The second (more problematic) part of the book, "The Fall," traces the decline of the cigarette ration, and tobacco use generally, in the Armed Forces. Bius skips ahead to 1973, when a confluence of circumstances, including the termination of US involvement in Viet Nam and increased awareness of the health hazards of smoking, brought an end to the cigarette ration. Other subjects treated in this part of the book include the transition to an all-volunteer military and the concomitant explosion of military responsibilities and defense budgets in the 1970s and 1980s. Bius describes the value of the young "soldier-starter" to the tobacco industry, and its efforts in Congress to preserve the link between military service and tobacco. The volume concludes with a discussion of the 1986 Report on Smoking and Health in the Military and accompanying Directive 1010.10, which established a baseline tobacco control policy for the services.

The "Marlboro Marine,"
photo by Luis Sinco

Bius offers a detailed, well written, and illuminating discussion of the Army's expanding role in the lives of soldiers from 1914 to 1986, especially with the move to an all-volunteer force, which found the Army attending to the needs of long-term enlistees and their families. He takes some fascinating detours into, for instance, debates about the relative benefits of a standing professional force versus one based on an as-needed draft. He has a knack for painting vivid pictures with telling anecdotes. For instance, he describes a First World War YMCA volunteer "laboring to light" a cigarette for a wounded man, which was "not a skill the Y Man had ever attempted, much less perfected. Successful in his task, he watched as the soldier drank in the tobacco, the effect was noticeable and immediate: instant calm in the midst of this soldier's panicked battle to stave off death" (33).

However, as a story specifically about tobacco and the military, this book is strangely constructed and limited. The title suggests that the focus is specifically the cigarette ration, but this ended in 1973, which makes the 1986 endpoint a puzzle. If the goal was to take a more comprehensive look at tobacco policy in the military (which would make sense), stopping at 1986 is curious, as policy changes and political struggles over tobacco use in the military started in earnest with the Directive, and continue today. For example, the submarine fleet went smoke-free only in 2010; when Secretary of the Navy Ray Mabus attempted to remove tobacco products from Navy Exchanges in 2014, he was stymied by Rep. Duncan Hunter (R-CA); and Hawaii's 2016 move to raise the age of legal purchase to twenty-one was met with the Navy's rather unexpected and voluntary decision to comply with the law.

The book also veers sharply between the political and the cultural. Part I highlights the role of tobacco in military culture, but the subject disappears in Part II. Similarly, there is a good chapter on the tobacco industry's political moves in the 1970s and 1980s to ensure its continuous access to "soldier-starters," but, since Bius jumps from World War II to the mid-1970s, there is nothing about its earlier efforts or its present relations with the military services. This may reflect the limitations of source materials in the Legacy Tobacco Documents Library (which run to millions of pages) or a conscious decision about source selection. Bius does not tell us.

The book ends by suggesting that tobacco use in the military is a problem largely solved. The author states that Directive 1010.10 changed official Army culture "in an instant" but also that "it would take years for the informal Army culture to change" (204). He notes that Directive 1010.10 set a "floor" for tobacco control policy, freeing leaders of military services or installations to set stronger policies, but barely touches on the interference by the industry and Congress that has frequently thwarted such efforts. Furthermore, over thirty years later, military tobacco control policy remains erratic. For example, basic (and sometimes advanced) training is tobacco-free; however, this has had the unintended consequence of making tobacco a reward for completing training. Additionally, many service members report that "smoke breaks" are allowed more often than breaks for other purposes. Tobacco products are still sold (tax-free) at commissaries and exchanges at prices supposedly matching those in civilian stores but often lower.

Most troubling is the author's failure to review the current status of tobacco use in the military and its effects on the health and safety of soldiers and other service members and their families, not to mention the associated financial strains on individuals and institutions. This is a serious omission. Bius himself does not seem to know what to make of the potential of military tobacco control policy. Noting that personnel deployed to combat zones use tobacco at higher rates, he laments that "some things never change" (273). This after earlier quoting a congressional panel regarding "draconian" tobacco control policy: "When the Army wants to enforce anything, anything is enforceable" (204). He also makes no overarching argument about the relationship between the military and tobacco use or the tobacco industry. As a consequence, the book's chapters, though individually clear and readable, fail to hang together in a coherent story.

Tobacco use in the military is frequently regarded as inevitable and natural. Joel Bius has taken an important step in clarifying the forces that forged and sustained this relationship in the twentieth century. We still need a fuller analysis of efforts by the military and its civilian supporters to undo those processes and foster a healthier fighting force.