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The long-standing military tradition of cheap cigarettes in military stores persists because of politics in the U.S. military sales system and tobacco industry pressures, according to a new study led by a UCSF School of Nursing professor.

These two factors receive additional strength from the perception within the military that tobacco use is a "right," says Ruth Malone, Ph.D., a registered nurse and senior author of the study and professor of nursing and health policy in the Department of Social and Behavioral Sciences.

Study findings are published in the February issue of the journal Tobacco Control.

Based on their examination of tobacco industry documents, searches of military Web sites and news databases, and interviews with principal informants, the study researchers found that the tobacco industry used its political clout in Congress and its ties to the military supply system to repeatedly thwart military efforts to raise the prices of tobacco in commissaries. Such efforts were successful in obstructing any price change for more than a decade.

When modest price increases were finally implemented in 1996, it was in the face of enormous pressure from congressional tobacco industry allies, according to Malone. Tobacco-friendly congressmen forced an assistant secretary of defense to undergo a public grilling at which he said in a 2005 interview with the UCSF researchers, "I could hear the snickers [of tobacco lobbyists] behind me. I think they were the ones that got these guys to have this hearing."

Malone adds, "A new generation of American troops will no doubt become addicted to cigarettes because of shortsighted policies that continue to subsidize low cost tobacco in military stores. It is past time for Congress and the Department of Defense to quit doing the work of the tobacco industry at taxpayer expense."

Interest in changing commissary tobacco pricing was sparked, Malone and colleagues found, by emerging research during the late 1980s documenting that tobacco use decreased troop readiness, even on a short-term basis. Furthermore, the U.S. Inspector General found that tobacco use cost the military eight times what it earned on tobacco sales when tobacco-related health care costs were considered.

As congressional and military health authorities began to act to raise prices, the tobacco industry mobilized to make the case that cheap cigarettes were a "benefit" for military personnel that should not be reduced, the researchers report. Calling on allies on the House Armed Services Committee, the tobacco industry pressured authorities to delay or scale back initiatives to raise prices, the study team says, and only through procedural maneuvering was the pricing policy changed.

While the study documents events from 1986 to 1996, the researchers note that in spite of tobacco control programs within the military, even today military personnel and their families continue to be able to buy cigarettes in military stores at prices lower than local retail, due to their tax free status. "A larger question is why, even today, cigarettes are still being sold through military outlets when it has long been clear that tobacco use harms the readiness of troops," Malone says.

Co-authors of the study are Elizabeth Smith, Ph.D., of UCSF, and Virginia Blackman RN, BSN, MS, CCRN, of the Naval Medical Center in Portsmouth, Va.

The study was supported by the National Cancer Institute.

UCSF is a leading university that advances health worldwide by conducting advanced biomedical research, educating graduate students in the life sciences and health professions, and providing complex patient care.