Attitudes to smoking on submarines: Results of a questionnaire study

Military Medicine,  Jul 2002  by Norris, William D

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Recent research has suggested that an advantage is conferred to smokers attempting to give up when counseling, follow-up, and nicotine replacement therapy, among other support, are offered in primary care.18.19 The use of a nicotine inhaler has been shown to enhance sustained long-term reduction in smoking, with 6.5% more of a treated group still not smoking at 2 years over matched controls.21 Counseling and encouragement to give up smoking form part of the consultation agenda when service members have routine medical examinations, and this is endorsed in the joint services publication dealing with these issues.21 The rate of quitting smoking in the general population of men aged 35 to 54 years has doubled in the last 50 years.17 Yet, although both authors of this report actively counsel smokers to quit, the success of this in the submarine environment has yet to be determined.

The provision of duty-free tobacco is inconsistent with promoting a nonsmoking policy among service personnel, with 94% of smokers indicating that they take advantage of the duty-free facility. Arguably, this does little to discourage smokers; furthermore, this is now particularly incongruous because increasing the cost of cigarettes has been shown to increase the number of smokers who quit.22 Recently, nicotine replacement products, which are the most effective treatment available to help smokers quit, have been made available through service channels by prescription. Bupropion (an atypical antidepressant that shows promise in helping smokers to quit23) has also been made available by prescription to service personnel.

Despite the apparent risks of ETS exposure, it could be argued that if the atmosphere purification equipment removes some of the contaminants of smoking, the risks to a ship's company may reduced. However, there is no evidence to support this. Even if the efficiency of ETS reduction were established, it would be ethically extremely difficult to establish a maximum permissible concentration of any known carcinogen contained in ETS. In any case, it is inevitable that some personnel will be directly exposed to ETS in performing their duties in compartments in which smoking is permitted.

Despite the United Kingdom law protecting the rights of nonsmokers, the current policy of smoking only in restricted areas appears to be well tolerated on board, with low percentages of smokers and nonsmokers stating that they felt it unfair to smokers. By law, however, an employer has the responsibility to protect all employees with or without their agreement, and employees have a duty to cooperate with the introduction of new health and safety regulations.2 So far, this has not been enforced in the submarine fleet by imposing a ban on smoking.

The subject of banning smoking in submarines has proved controversial with submariners, and this article is the first to report the attitudes of an entire unit-based work force within the armed services. The decision in the year 2000 not to enforce a previously proposed Royal Navy submarine fleet-wide ban of smoking on board may reflect consideration of this controversy.