Are Veterans Really Different? The Feasibility of Smoke-Free VA Hospitals

Anne Joseph, MD, MPH; Jane Korn, MD
JAMA. 1988;260(11):1551. doi:10.1001/jama.1988.03410110059012.
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To the Editor.—  The Veterans Administration (VA) health care system is the largest in the nation, serving approximately 3.4 million patients per year. Many patients have medical conditions related to smoking, such as lung cancer, head and neck cancers, chronic obstructive pulmonary disease, and atherosclerotic heart disease. In spite of this, the VA has been reluctant to impose restrictions on smoking in its medical facilities.1 In the past, VA hospitals have distributed free cigarettes to patients, and many still provide tobacco products in the canteen service.Why hasn't the VA taken a more active role in discouraging smoking? Many have the impression that the majority of veterans are smokers, who would vehemently object to restrictive smoking policies. Others question the fairness of smoking limitations to patients who smoke as a result of the military's past practice of distributing free cigarettes. Reluctance to deprive those veterans with chronic disabling illnesses


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