“Everywhere the Soldier Will Be”: Wartime Tobacco Promotion in the US Military

Abstract

Deployment of young Americans in military engagements places them at increased risk for not only war hazards but also tobacco addiction and disease. Tobacco use diminishes troop health and readiness, and increases medical and training costs.

Military tobacco control efforts began in 1986, yet tobacco use remains high. To determine whether and how the tobacco industry targets military personnel in wartime, we analyzed internal industry documents about the Gulf War (1990–1991) and constructed a historical case study. During this conflict, tobacco companies targeted troops with free cigarettes, direct advertising, branded items, ways to communicate with family, and “welcome home” events. Military authorities sometimes restricted this activity, but frequently enabled it; tobacco companies were regarded as benefactors.

Considering tobacco use a benefit undermines military health priorities. Stronger policy is needed to reframe tobacco use as incompatible with military ideals.

DESPITE DECLINES IN CIVILIAN smoking rates in the United States and tobacco control efforts in the US military, tobacco use prevalence in the military remains high, at 32.2% in 2005.¹ Prevalence decreased between 1980 and 1998 (51.0% to 29.9%)¹; however, it has increased since then.² The military population of 1.4 million active duty service members skews toward likely smokers: young adults, high-school educated, and African Americans³ near the typical age of smoking uptake.⁴ Recruits are more often established smokers than are those who do not enlist,⁵ and despite mandatory abstinence from tobacco use during basic training, subsequent relapse or new uptake is common.⁶ The Veterans Health Administration estimates that veterans also have significantly higher rates of smoking than do civilians.⁷ Smoking diminishes even short-term troop health and readiness^8,9 and increases medical and training costs.^10,11

During the first Gulf War (1990–1991), smoking prevalence rose among deployed US Naval personnel¹² and US Air Force women,¹³ and US Navy personnel who were already tobacco users increased their use.¹² We mined internal tobacco industry documents to explore how tobacco industry and military activity during this period may have contributed to this increased tobacco use.

BACKGROUND

Tobacco companies have targeted US military personnel¹⁴ since World War I.¹⁵ Cigarettes had been regarded as a physical and moral hazard,¹⁶ but by 1918, previously anticigarette organizations and the military were giving them to troops.¹⁵ British writer G. K. Chesterton compared the risks of smoking in combat to “the perils of gluttony in a famine.”^15(p51) Cigarettes were said by the New York Times to “lighten the inevitable hardships of war,”^15(p52) and were described by a popular periodical as “the last and only solace” of the wounded.^15(p52) Medical knowledge about the hazards of smoking was rudimentary. However, although knowledge has increased, the association between smoking and military service persists.¹

Furthermore, different sectors within and outside the military have different, and sometimes conflicting, concerns about tobacco use. For example, the military suspended cigarette rations in 1975, but continues to sell untaxed cigarettes in military stores, called commissaries and exchanges.¹⁷ Profits from these sales support Morale, Welfare and Recreation activities.¹⁷

In 1986, in response to a study revealing that health care related to tobacco use cost the Department of Defense (DOD) $209.9 million annually, the DOD released Health Promotion Directive 1010.10. This directive established some clean indoor air policies and cessation programs, and prohibited sponsorship of Morale, Welfare and Recreation program activities (e.g., entertainment or athletic events) that identified a tobacco product or brand.¹⁸ However, sponsorship restrictions were eased in February 1988. Although soliciting sponsorship from tobacco companies remained prohibited, branded promotions could be accepted if offered, and if “the company sponsors similar events in civilian communities.”¹⁹

Since Directive 1010.10, numerous stronger tobacco control policies have been proposed by commanders wishing to promote health, but many have been weakened or withdrawn because of pressure from members of Congress representing states in which tobacco is grown.²⁰ Thus, some parts of the military see profits from tobacco sales, some are concerned about health, some are concerned about health care costs, and all are sensitive to Congressional demands.

METHODS

Nearly 10 million tobacco industry internal documents have been released through litigation.²¹ We searched the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) and http://tobaccodocuments.org by using a snowball strategy²² beginning with keywords (e.g., “desert storm,” “Saudi Arabia,” “gulf war”). Additionally, we searched for news stories on LexisNexis and NewsBank to contextualize and corroborate findings from the documents. Data from approximately 630 documents, dated 1986 to 2001, were assembled into a historical case study.^23,24 Descriptive case studies are a form of social science inquiry that assembles multiple sources of evidence to analyze a phenomenon in context.²⁴

RESULTS

The tobacco industry targeted deployed troops and their families in a variety of ways. Here, we discuss 5 promotional strategies and military responses to them.

Free Cigarettes

American troops were deployed to Saudi Arabia in August 1990.²⁵ By September, campaigns were underway to send troops “care packages” of food, personal care products (e.g., lip balm), and cigarettes.^26,27 A retired army colonel requested donations of cigarettes from tobacco companies Lorillard,²⁸ Philip Morris, Brown & Williamson, and RJ Reynolds.²⁹ Philip Morris sent 10 000 cartons of Marlboros via the 82nd Airborne Division from Pope Air Force Base in North Carolina.³⁰ The cigarettes were distributed by the United Services Organization³¹ to members of the US Army, Air Force, and Marines.³² (One study found that among US Navy personnel deployed to the Gulf, 1.6% of smokers and 2.1% of smokeless tobacco users received free tobacco products.)¹²

The cigarettes reportedly arrived on September 26, 1990³³; however, on October 4 the DOD claimed to have had “no luck in confirming” the shipment and that “if it was done, it was not done through military channels.”³⁴ The next day the DOD reported that cigarettes were “mistakenly” shipped, but that those responsible had been reminded of DOD policy against distribution of free cigarettes and no more were sent.³⁵ A donation, probably from Brown & Williamson,³⁰ (which “had manufactured a special run of 12,000 cartons”³⁶), and donations from other companies “of an estimated 30,000 cartons,” were also stopped.³⁷ However, later that month, the Defense Logistics Agency still suggested tobacco products as an “acceptable donation.”³⁸ (The Defense Logistics Agency, a part of DOD, is responsible for providing “almost every consumable item America's military services need to operate” in combat.³⁹)

A Philip Morris spokesman professed “surprise” at the DOD's reaction.⁴⁰ The company, he claimed, was responding to soldiers’ requests,^33,40 and Philip Morris planned to donate cigarettes “until the mobile [military stores] were in place” and soldiers could buy them.⁴⁰ He denied “trying to capitalize” on the war.³⁴

The American Tobacco Company asked the US Army and US Air Force Exchange Service (AAFES), which oversaw the military stores, to allow them to send cigarettes. The American Tobacco Company planned to send 6000 packs with name collection stickers on them; names collected would be sent free cigarettes while overseas and upon their return to the United States would be sent coupons.⁴¹ This plan likely was not approved, as a few days later, a Pentagon spokesman said that DOD forbade sending cigarettes.³⁵

Echoing the opinions of World War I–era commentators, the North Carolina congressional delegation found this policy “more than a little ironic” for troops in a “potential combat situation” and urged Secretary of Defense Richard Cheney to reconsider.⁴² They also wrote to Les Aspin (D-WI), Chairman of the House Armed Services Committee.⁴³ Describing smoking as a “comfort” and the claim that it was “contrary to combat readiness” as “unbelievable,” the letter asserted that it would be “difficult, if not impossible” to explain how “potential exposure to combat is less dangerous than the receipt of free cigarettes.”⁴² (The comic strip Doonesbury satirized this logic, with Philip Morris “representative” Mr Butts reminding soldiers that cancer was of no concern because “you might not be around 20 minutes from now.”^44[p88]) Reportedly, Aspin also wrote to Cheney, asking why only tobacco products were “not welcomed by the military” as donations.⁴⁵ The Assistant Secretary of Defense for Health Affairs refused the congressman's request, saying that “free distribution of tobacco products could seriously jeopardize” efforts to reduce tobacco use, and assuring them that service members could purchase tobacco at military stores.⁴⁶

Sales and Promotions

Their donations rebuffed, Philip Morris and RJ Reynolds extended promotions to deployed troops. Philip Morris partnered with the United Services Organization and other companies to send “Oasis” packages including food from Kraft (then a Philip Morris subsidiary), and “Marlboro racing team caps and playing cards.”⁴⁷ RJ Reynolds noted that “Troops in Saudi Arabia definitely know that ‘Camel Joe’ is behind them” as they had received “over 5,000 packs of Camel playing cards … [and] a variety of premium [i.e., branded] items including sunglasses, audio cassettes and cup cozies.”⁴⁸

RJ Reynolds initially saw Desert Storm as a sales opportunity.^49,50 However, some in the company were concerned that direct mail sales to troops might cause “adverse public and government relations.”⁵¹ Direct sales would bypass AAFES, which ordinarily monopolized sales to deployed troops. The resulting loss of revenue for AAFES might anger those in charge of military sales, and damage RJ Reynolds’ relationships with them.⁵² Internal memos suggested “improving the distribution and retail problems” (i.e., sales through AAFES).⁵³

These problems profited Philip Morris. In November 1990, the Philip Morris Military Sales department alerted President and CEO William Campbell that the “troops in Saudi Arabia are out of menthol cigarettes.”⁵⁴ In response, Philip Morris air freighted 10 million Alpine Lights⁵⁵ and 15 million Marlboro Lights to the Saudi Arabia AAFES Distribution Center.⁵⁶ The shipment was expedited by the federal government, which gave Philip Morris permission to use tax-stamped product for these untaxed sales.^50,55 As a result, these Philip Morris brands had a monopoly “during the entire month of February [1991].”⁵⁷

Despite its policy of promoting smoking prevention and cessation,¹⁸ the military assisted the tobacco companies. For instance, in June 1991, Philip Morris had problems getting cigarette shipments to military stores in Saudi Arabia. However, they managed to send “periodic shipments by Military Air Command planes”⁵⁸ and a month later continued to air ship Marlboros “at U. S. government expense.”⁵⁹

Operation Desert News

Operation Desert News was a civilian's project to send magazines to troops.⁶⁰ The donated magazines, including Life, Adventure Comics,⁶⁰ Smithsonian, and Redbook,⁶¹ among others, were to have “covers decorated in camouflage and bearing the names of corporate sponsors.”⁶⁰ The only sponsor was RJ Reynolds.⁶²

The DOD halted the first shipment (between 100 000^61,62 and 200 000^63,64 magazines) because the covers had RJ Reynolds’ name on the front, and a Camel ad on the back.⁶² Timothy Karnes, Operation Desert News’ organizer, claimed that DOD knew about RJ Reynolds’ sponsorship, but then admitted that the draft cover he had submitted to the DOD for approval did not mention RJ Reynolds or Camel.^62,65 On December 21, 1990, a week after the shipment was stopped, DOD said the magazines could only be sent with a disclaimer of military endorsement on the front and the advertising removed.⁶² Karnes refused the deal,⁶³ and threatened to sue the DOD and the Defense Logistics Agency, saying that RJ Reynolds “deserve[d]” to have its ad on the news covers because it had contributed $250 000.⁶³

When Karnes insisted on including the advertisement, a DOD spokeswoman responded, “Then he's never going to get it shipped.”⁶³ However, in late January DOD backed down after “appeals” by South Carolina Senators Ernest Hollings (D-SC) and Strom Thurmond (R-SC).⁶⁶ The magazines were shipped with disclaimers on both front and back.⁶⁶ The size of the disclaimer is unknown; on other materials the disclaimer is half the size of the surgeon general's warning.⁶⁷ The program violated military policy, which forbade tobacco-branded promotions directed primarily at military personnel.¹⁸ The DOD paid to deliver the magazines.⁶⁶

News accounts referred to RJ Reynolds’ payment variously as a “donation”⁶⁶ and as a “contribution” made “in exchange” for the advertisement.⁶⁴ (The biggest expense was $60 000 to print the covers.⁶⁶) The payment covered 6 proposed mailings of Operation Desert News; however, in mid-April RJ Reynolds reported that Operation Desert News had “tentatively agreed to sever contract”⁶⁸ because troop withdrawals had begun, and that the company expected $175 000 of its original $250 000 donation to be returned.⁶⁸ Though Karnes gave RJ Reynolds credit for a $250 000 “contribution,” RJ Reynolds actually paid only $15 000 above the cost of its advertisement.

Marlboro Voice Card

The “Marlboro holiday voice card” program, held on 10 military bases, invited family of deployed personnel to record a message onto a chip inserted into a greeting card. Philip Morris paid for delivery to Saudi Arabia.⁶⁹ The “rationale” for the program was “positive publicity and goodwill associated with Marlboro” and “awareness and visibility of Marlboro among young adult smokers.”⁶⁹ Philip Morris also hoped to use publicity about the event to “reach a broad base of opinion leaders.”⁷⁰ (RJ Reynolds participated in a less-publicized program, donating “over 300 blank Camel video tapes” to a project that sent Christmas messages to troops.⁷¹)

Voice card implementation.

The voice card program cost $1 500 000, of which the brand contributed $1 million, and Philip Morris’ Consumer Promotions Development Group the rest.⁷² (This suggests that the voice card was primarily about cigarette marketing, as philanthropic efforts are usually paid for by Corporate Affairs.) Publicity included advertisements in base newspapers and USA Today,⁷³ a press release featuring touching messages sent (e.g., a birth announcement),⁷⁴ and video coverage of troops receiving the messages.⁷⁵ To “minimize any attacks on Marlboro,” publicity was avoided in the New York Times, Washington Post, and Wall Street Journal.⁷⁶

A limited lead time meant that fewer family members than expected recorded voice cards,⁷⁷ so after the first day, Philip Morris announced that “due to overwhelming demand” some bases were allowing the general public to record cards to “Any Soldier, Saudi Arabia.”⁷⁸ Even so, only 23 556 of Philip Morris’ 83 750 chips were sent.⁷⁷ (In its publicity, Philip Morris claimed 80 000 had been used.)^79,80 Still, Philip Morris concluded that “our primary objective of publicity and goodwill was achieved.”⁷⁷

A draft of the card depicted a man on horseback dragging a Christmas tree through the snow to a ranch house. The message inside: “Season's Greetings from Marlboro Country.”⁸¹ Newspaper accounts give similar descriptions of the image,^82,83 but the text on the final version was cut to “Season's Greetings.”⁸⁴ A Philip Morris newsletter described it as “a Western winter scene out of Marlboro Country,”⁷⁹ and Philip Morris referred to the cards as “Marlboro Holiday Voice Cards.”⁷⁷ However, when questioned about the card's similarity to Marlboro ads, a Philip Morris spokeswoman claimed she saw “no resemblance” between the two, remarking, “You're the first person to suggest there's any similarity … I don't even think that's a cowboy.”⁸³

Reaction to the voice card.

Civilian tobacco control advocates criticized the program as “devious,” “sneaky,” and violating the spirit of DOD policy.^82,83 A Seattle Times editorial remarked, “commercial opportunism rarely gets this crass.”⁸⁵ However, there was no action against the card. In contrast to Doonesbury strips about the free cigarettes, Doonesbury strips about the voice card focused on the pleasure and gratitude of the recipients.⁸⁶

The voice cards and the company garnered publicity and praise. Philip Morris claimed 94 million media impressions were made about the voice card.⁷⁶ The video supplied by Philip Morris⁸⁷ was aired in Australia, Japan, and Europe, mentioning Marlboro 85% of the time.⁷⁷ Philip Morris received more than 300 thank you letters from card senders.⁸⁸ The writers were grateful to be able to communicate with their loved ones, praising the company for its “generosity,”^89–91 “thoughtfulness,”⁹² “kindness,”⁹³ and “appreciation for the sacrifices made” by service members.⁹⁴ One smoker claimed to have switched to Marlboro out of gratitude.⁹⁴

Nonsmokers also approved. One wife reported that although she had asked her husband to quit smoking, “If we ever get to see him again, I don't believe I will ever fuss about it again.”⁹⁴ Even a woman who disliked “supporting a company the product of which slowly kills, not just the ones who use its product but those around who suffer indirectly,” praised Philip Morris for helping the morale of our soldiers in Saudi Arabia, especially in such a clean, HEALTHY manner.”⁹⁴ Another reported that although she had to “give up the pleasure of your cigarettes” a decade previously, “in 15 minutes and a letter from my husband saying he listens to my voice everyday Marlboro gave me pleasure again.”⁹⁵ Officers at the host bases also wrote to express their thanks.^96,97

The program was in blatant violation of DOD policy regarding tobacco-branded programs directed at military personnel.¹⁸ This apparently concerned Philip Morris, as the company requested advice from counsel.^98,99 Nonetheless, Philip Morris received permission to carry out the program from the Defense Logistics Agency¹⁰⁰; the Morale, Welfare and Recreation headquarters of the services¹⁰¹; and the base commanders.^102,103

Afterward, the Deputy Assistant Secretary of Defense for Military Manpower and Personnel Policy wrote to Philip Morris reminding the company of the policy prohibiting “promotions that directly or indirectly identify a tobacco product.”¹⁰⁴ The letter suggested that, for any “similar future endeavors” Philip Morris should use the corporate name, and thanked Philip Morris for its “patriotism and concern for our Service members.”¹⁰⁴

Philip Morris Director of Communications John Zuke had expected this “mild rebuke.”¹⁰⁵ A news story criticizing the program had “made the Pentagon so nervous” that they considered halting it; in response, Zuke reported that he had “interceded” at the Defense Logistics Agency, where the scolding letter was “hatched” as a way to “hold the Pentagon officially blameless if a major flap developed.”¹⁰⁵

Welcome Home Events

Troops were withdrawn in 1991; however, Philip Morris Vice Chairman William Murray and Mike Szymanczyk, senior vice president of sales, were “keenly interested in capitalizing on the successful military operation” and “continuing the association we started last year with the troops.”¹⁰⁶ By June of 1991, a military sales manager reported, “Over forty locations now have welcome home signs in place featuring Marlboro brand identification.”⁵⁹ The company “produced the largest ‘welcome home’ event for the Desert Storm troops at Camp Lejeune Marine Base”; 80 000 people attended.¹⁰⁷ Events held on bases in Germany also featured “extensive signage for Marlboro.”⁵⁹

For returning troops, RJ Reynolds’ Camel brand developed the “targeted yet subtle” message, “Shake That Sand Out.”¹⁰⁸ Designed to be “flexible,” it could be used to “say ‘welcome home’” and be used at general beach-themed events.¹⁰⁸ RJ Reynolds planned to “be everywhere the soldier will be for the next six months.”¹⁰⁸ RJ Reynolds sponsored events at Fort Hood, Texas, Fort Bragg, North Carolina, Norfolk, Virginia, and Oceanside, California, all on or near bases.¹⁰⁹ In addition, the “Chief of Staff of Special Forces in Desert Storm presided over [Winston Drag Racing] as Grand Marshal”; the event “saluted all American Forces involved in the Persian Gulf” and “all military personnel were admitted free.”¹¹⁰

DISCUSSION

Research about military tobacco use has primarily been quantitative, focusing on prevalence rates rather than on the influence of the tobacco industry^14,17,20 and institutional or cultural factors that promote tobacco use in the military.^{14,17,20,111–113} This study illustrates some of the dynamics that have prevented the military from meeting its goals for reducing tobacco use. Incremental changes in military tobacco policy have been made, including increased commissary prices¹⁷ and clean indoor air regulations.¹¹⁴ However, this study suggests that there are structural and cultural obstacles to strong tobacco control policies and their effective implementation in the military.

First, during the Gulf War, many military authorities violated the spirit, and sometimes the letter, of military policy, including shipping cigarettes at taxpayer expense and facilitating marketing to military personnel. Long-standing tradition and the efforts of the tobacco industry maintained a framework for tobacco use as a comfort or a right. Prohibiting tobacco use and promotion was thus positioned as a deprivation, especially for deployed troops, making tobacco control policy appear harsh. In addition, when troops are in immediate danger, the seemingly remote hazards of tobacco use were dismissed by troops, their families and supporters, the military, and Congress.

Second, troops may be particularly vulnerable to promotional offers such as branded playing cards or magazines because they have needs—not strictly military—that the military cannot address. During the Gulf War, tobacco company marketing efforts were regarded as benefits, providing sundries, communication with loved ones, and otherwise unavailable luxuries. The muted response of health organizations to the Marlboro voice card—too weak to provoke the DOD into publicizing its “rebuke”—may be attributable to this framing.

Finally, tobacco control policy affects many different activities and systems, involving people whose primary concerns are, for instance, sales, advertising, and distribution rather than health. Those who perceived their roles as maintaining troop morale or delivering needed goods—for instance, those who approved the Marlboro voice card program—may not have appreciated the importance of their roles in tobacco control. Thus, they undermined tobacco-control policy in the service of their stated duties, with encouragement from the tobacco industry.

Limitations

The document set collected for this study was not comprehensive, but is a selection of litigation-related material. As no tobacco litigation to date concerns the military, there may be documents unavailable for analysis that contain additional information. We also may not have identified all relevant available documents because of their volume. Military documents were not readily available; many of those cited were retrieved from the tobacco document archives.

Conclusions

Smoking rates in the military are not declining. In part, this may be because military personnel smoke as a response to boredom, anxiety, and stress, which are likely exacerbated for deployed troops.^1,111 Deployment is associated with smoking uptake and recidivism^115–117; one recent survey of a battalion deployed to combat operations in Iraq found that 52% smoked.¹¹⁵ Thus, the current deployment of thousands of young Americans to Iraq and Afghanistan in military engagements places them at increased risk from the hazards of war, and also increased risk of addiction and disease from tobacco.

As a hierarchical institution, the military communicates important messages through orders. The areas in which the military has met health objectives are those where regulations enforce healthy behaviors, such as exercise and seat belt use.¹ Tobacco remains culturally accepted, and a mixed message prevails: tobacco use is discouraged (e.g., donations are forbidden), but accommodated (e.g., purchase is facilitated). DOD regulations are not adequately supporting tobacco use prevention and cessation.

Attitude change frequently follows policy change,^118,119 and, thus, policies require strong leadership from advocates.¹²⁰ Being tobacco-free should be mandatory and promoted as a point of distinction and pride, like uniforms, haircuts, and fitness. Military tobacco control policies should characterize tobacco use as unmilitary, making tobacco control important to all personnel, regardless of their primary functions. These policies should include prohibiting sales through military outlets, making bases 100% smoke-free, and, with adequate cessation support for current users, requiring personnel to abstain from tobacco. Without such policies, there are unlikely to be widespread changes in military tobacco culture and use, personnel will continue to be vulnerable to tobacco industry marketing efforts, and more veterans will return from war addicted to tobacco.