Tobacco-Free Living

TFL Guidelines and Initiatives for Action Officers

Last Updated: December 18, 2017
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Tobacco Free Living Policies

Army Regulation 600-63, Army Health Promotion External Link

Tobacco Control Program (Pages 30-32)

  • Tobacco Use Counseling during Oral Health Exams - Chapter 5-5
  • Promotion of Tobacco-Free Environment -  Chapter 7-2
  • Policy for Controlling Tobacco Use, Signage, and Enforcement - Chapter 7-3, 7-4, 7-5

MEDCOM Tobacco Free Living OPORD 15-48 External Link  (on AKO - CAC required)

All MEDCOM facilities will promote Tobacco Free Living (TFL) workforces and implement Tobacco Free Medical Campuses (TFMCs) in support of TSG Army Medicine Healthcare Covenant. TFL and TFMCs provide safe environments for patients to receive their care.

TFL includes tobacco prevention, incremental tobacco reduction, and control. TFL will be implemented across the enterprise in order to create a tobacco free community that promotes the overall health of military personnel, Family members, retirees, and all employees on MEDCOM campuses.

Each command has identified an Action Officer (AO) to assist with policy implementation.  

The TFL AO role is to:

  • coordinate actions related to the MEDCOM  TFL OPORD
  • attend mandatory trainings and In Progress Reviews with HQ MEDCOM and the APHC (Provisional)
  • support data collection and evaluation efforts
  • report policy status to HQ MEDCOM and APHC (P) as requested.  

Data collection starts immediately with an assessment of the local TFL environment and policies within/surrounding the MEDCOM facility using the assessment tool, the Quantitative Indicators for Tobacco Systems (QITS) assessment tool.  See the details on QITS in the 'Data Collection' section below.  Submit the QITS tool online NLT 4 Dec 15. 

CHECK OUT THE TOBACCO CESSATION WEBINARS (PHC) to help you succeed as a TFL AO!



Tobacco Free Living Policy Reinforcement

AMEDD 2020 Campaign Plan External LinkThe Army Medicine 2020 Campaign Plan operationalizes the vision and strategic imperatives to ensure that the Army leads the Nation in health. This plan uses three Lines of Effort (LOE) - Increase Capacity, Enhance Diplomacy and Improve Stamina - to achieve the desired end state. Tobacco-Free Living is LOE 3.3.1 on page 28.

Healthy Base Initiative External Link  The Army and the Army MEDCOM support the collaboration between Department of Defense (DoD) Health Affairs and Military Community and Family Policy in the Healthy Base Initiative (HBI). Tobacco Reduction is one of the four focus areas of the HBI. One key activity of the HBI is to create tobacco free environments and measure tobacco reduction. This initiative supports Operation Live Well objectives and aims to achieve the Department of Defense goal of tobacco free installations by 2020.

National Prevention Strategy: America's Plan for Better Health and Wellness External Link(Jun 2011) The National Prevention Strategy is the nation's first such strategy. It is a critical component of the Affordable Care Act, and it provides an opportunity for the nation to become healthy and fit. The Strategy intends to move the nation from a system of sick care to one based on wellness and prevention. It focuses on housing, transportation, education, workplaces and environments as major elements that impact the physical and mental health of Americans.

Tobacco Prices Going up  in DoD Stores (Military Times, April 2016) External Link

APHC HIP eCatalog Check out APHC TFL and tobacco cessation educational materials!

Work Shifts Union Guide to Tobacco: TOBACCO & LABOR UNIONS External Link

DoD/VA Clinical Practice Guidelines (CPG) The VA/DoD Evidence-Based Practice Work Group (EBPWG) has adopted the Treating Tobacco Use and Dependence, 2008 Update External Link clinical practice guideline developed by the U.S. Public Health Service. This guideline describes the critical decision points in the Management of Tobacco Use and provides clear and comprehensive evidence based recommendations incorporating current information and practices for practitioners throughout the DoD and VA Health Care systems. The VA/DoD Tobacco Use Cessation CPGs External Link are intended to improve patient outcomes and local management of patients who use tobacco products.

Data Collection, Evaluation and Reporting

Quantitative Indicators for Tobacco Systems (QITS) TFL AOs will conduct an assessment of current TFL compliance using the QITS tool.  QITS is the online tool to assess the tobacco environment promoting tobacco-free living both within the MEDCOM facility and across the installation. QITS helps to evaluate the policy, environment, and clinical practices related to tobacco use and tobacco exposure at the MEDCOM facility.  Tool completion time varies based on the AO's experience and knowledge of tobacco policies and procedures, as well as the size of the MEDCOM facility.

Click here for a pdf version of the QITS tool (APHC)- It is best to complete the survey on this hard copy first!!

Click here for the link to the QITS tool External Link   Submit the QITS tool online NLT 4 Dec 15.  FYSA, in May 2016, a second data call for completing the QITS assessment will occur to measure local TFL compliance after full policy implementation. 

TFL AOs, through coordination with MTF/MEDCOM facility leadership will ensure timely and widest dissemination of a TFL survey to all MEDCOM employees who work within the tobacco free campus boundaries. The target audience applies to all Medical, Dental, Veterinary, Warrior Transition Command personnel within the MTFs, RMCs/RHCs, AMEDDC&S, DENCOM, MRMC, WTC, APHC, and OTSG.  The purpose of the survey is to assess MEDCOM employee knowledge, beliefs and behaviors related to the current TFL policy.  Tool completion is expected to take between 5-10 minutes.  Dissemination of this survey will occur at two different time points (Nov 15 and May 16), both by official MEDCOM OPS taskings.  Click here for the link to the TFL Survey for MEDCOM employees within TFC boundaries  External Link  

QITS Webinars For comprehensive and detailed guidance for completing the QITS tool, TFL Action Officers were offered a TFL webinar via DCS.  Click here to access a recording of this webinar. External Link (COMING SOON!!!)

Tobacco Cessation Strategies

UCANQUIT2 External Link Department of Defense Tobacco Cessation Web-based Support

TRICARE Tobacco Cessation Program Fact Sheet External LinkAccess a comprehensive collection of FREE TRICARE tobacco-cessation tools.

Armed Forces Tobacco Cessation Guide External LinkGuide to help military treatment facilities make tobacco cessation a routine part of care for all their beneficiaries.

U.S. Army MEDCOM Quality Management Office CPG Product Selection and Shopping Cart. External Link  A wide variety of patient-focused videos, brochures, wallet cards, and posters; as well as provider-focused reference cards and implementation tools.

The Guide to Community Preventive Services External Link A free resource to help choose programs and policies to improve health and prevent disease in your community. Systematic reviews are used to answer these question determine which program and policy interventions have been proven effective.  Find details in the tobacco section. 

Women and Smoking Cessation Handbook External Link VA developed the Women & Smoking Cessation Handbook to provide clinical guidance on evidence-based smoking cessation care targeted to meet the needs of female Veterans. Wherever possible, this resource draws upon evidence-based and gender-specific literature for information and treatment guidance.

Combating Tobacco in Military and Veteran Populations External Link  (2009)  This Institute of Medicine (IOM) report provides recommendations to the DoD and VA on improving the health of active duty and veteran populations with regard to tobacco use initiation and cessation. Document is available at cost and/or can be obtained free of charge as a download for MyNap account members.

Capturing Tobacco Use Rates The Army captures Soldier tobacco use rates from data reported by DENCOM's Corporate Dental System (CDS). This system captures tobacco use at the annual dental exam and uploads results monthly for the number of Soldiers reporting whether they use smoke, smokeless or both. Tobacco use metrics may be accessed from the Public Health Management System Dashboard. External Link

News You Can Use

Electronic Cigarettes  E-cigarettes are plastic and metal devices that heat a liquid nicotine solution in a disposable cartridge, creating vapor that the "smoker" inhales. With electronic cigarettes flavors like bubblegum, buttered popcorn, fudge and cookie dough, and the fact that there is apparently no age restriction on their sale to minors in most states, the devices are becoming enormously popular among teens and even those younger. Little is known about what the estimated million or more people using them are sucking into their lungs.

FDA and E-Cigarette Regulation External Link   The U.S. Food and Drug Administration proposed asserting its authority over e-cigarettes, cigars, pipe tobacco and nicotine gels. The rule makes e-cigarettes off-limits to kids under 18 and would require makers to tell the agency what is in thier products.

White Paper: Electronic Cigarettes and the Indoor Environment (American Industrial Hygiene Association, 2014) External Link

E-Cigarette 2011 DOD SHRUB Report External Link (Page 170) Frequency of smokeless tobacco use, including new forms of smokeless tobacco by service.

Electronic Cigarettes in North America: History, Use and Implications for Smoking Cessation External Link   Designed to mimic the look and feel of tobacco cigarettes, electronic cigarettes (e-cigarettes) may facilitate smoking cessation. Article reviews the available data on the efficacy and safety of e-cigarettes for smoking cessation and to consider issues of product awareness and regulatory and ethical concerns.

Tobacco Product Labeling

FDA issued new rules for a variety of tobacco products External Link, including smokeless tobacco product warning labels and "light," "low," "mild" or similar descriptors for tobacco products. These new laws are expected to have a significant public health impact by decreasing the number of people using tobacco products, resulting in lives saved, increased life expectancy, and lower medical costs.