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With the rate of newly enlisted and discharged soldiers who smoke remaining steady in recent years - and among women soldiers even rising - the Israel Defense Forces has for the first time trained personnel whose orders are quite simple: get soldiers to kick the smoking habit.
Lt.-Col. Salman Zarka, the man in charge of health in the bureau of the Israel Defense Forces' Chief Medical Officer, discussed such activities with The Jerusalem Post in honor of World No Smoking Day, which was marked on Thursday.
Zarka said that 13 people have been trained to lead smoking cessation courses for soldiers, while dozens more have completed a medics' course for health promotion among the troops and even among school pupils who will enlist in the years ahead.
In addition, he said "a way will be found" to prevent distribution of free cigarettes to non-smoking soldiers in battle. This was common, including during the Second War in Lebanon, and may have led to numerous soldiers getting addicted to tobacco. "We hope this problem is behind us and will find a creative solution to this problem," he said.
Zarka, a Druse physician born in the Galilee town of Peki'in who studied medicine at the Technion's Rappaport Medical Faculty and earned a master's degree in public health at the Hebrew University-Hadassah Braun School in Jerusalem, said he is worried about the latest statistics.
A total of 31.6% of new draftees smoked in 2006, and 41.6% of those discharged in the same year smoke. While concerned about male soldiers, he is even more so about trends among women soldiers: Fully 28.9% of newly drafted women smoke, compared to 38.5% of those who were discharged at the end of their service last year. In the general population, 25% smoke, but most young people get hooked on tobacco way before they go into uniform: The average age of taking a first puff is down to 15.5 years.
There is some good news, however. Soldiers who do indulge smoke fewer cigarettes per day than in the Eighties: 20 by men and 14 by women then, compared to an average of 14 by men and 9.5 by women last year. Foreign studies have shown that people in their late teens and early 20s are more likely to smoke whether they are in the military or not, so IDF service - admittedly stressful - is not necessarily the cause of soldiers getting hooked on tobacco, he noted.
Zarka, married and the father of three, told the Post that he himself gave up the habit five years ago, without any help, after having smoked for "many years." He calls himself "one of the lucky one to three percent who quit by themselves."
While the IDF's health promotion branch does not spend most of its effort on fighting tobacco use - it aims at preventing disease with a focus on water and food, by deciding vaccination policy and conducting health promotion studies - he said there was no doubt that tobacco use was a major danger to soldiers' well being. Zarka was surprised by soldier surveys in which "only" 38% of men and 28% of women draftees admit that they had smoked a hookah (narghile) at least once. It seems likely, he said, that the survey did not reflect actual hookah smoking, which was no less dangerous than cigarette smoking, as civilian surveys among youths show it as much higher.
Israel's laws that bar smoking in public and work places (except in designated separate and ventilated smoking rooms) were in effect in the IDF, adds Zarka. He thinks it's impractical to bar smoking completely (by eliminating smoking rooms and prohibiting it outdoors), as it would be very difficult to enforce, and coercion is not very effective. "They tried coercion for a while in the US Marine Corps, but it didn't work, and it was stopped," he said.
Unfortunately, packs of cigarettes are still freely sold in IDF canteens, even though some countries have barred tobacco sales in military installations. Zarka explains that the "IDF approach is not to use force for such things," but the Post learned that the main reason why cigarette sales in canteens have not been halted is because the IDF chief attorney's office was concerned that the IDF could be sued by tobacco companies demanding "freedom to make a living."
Smoking is not permitted in tents, permanent barracks and offices, but it is allowed outdoors, Zarka said. When the rules are violated, soldiers can complain to their commander, and the violator can be judged and punished. Asked what happens if the commander himself smokes in places where it is forbidden, Zarka said that there were other ways to complain, including by e-mail to his office. But as he is not in charge of enforcement and punishment, he didn't have figures on the number of fines or other punishments that have been handed out.
The Post also learned that the IDF bars smoking at meetings "unless all agree that smoking is permitted," which can lead to lower-level non-smoking soldiers being deterred from standing up for their rights to clean air. A proposal to stop this practice has been circulated in the IDF for approval over the past few months, but it has not yet been put into force.
Educational efforts, Zarka continued, are more effective against smoking in the IDF than coercion - thus the pilot program of smoking cessation trainers and health promotion medics are so important. "At 18, nicotine addiction is not so strong that young smokers can't quit," he explained. New draftees receive educational material about smoking, and unit physicians also try to educate about the risks of smoking, especially to those who want to be in fighting units. Military doctors who themselves smoke can ask to be excused from this task if they feel they are a bad example to soldiers, Zarka said.
He believes in educating parents about the dangers of smoking, and reaching children as young as kindergarten age. He himself has lectured on cigarette risks at kindergartens in the Druse village of Usfiya and found it "very successful."