American sailors and Marines stationed in Iraq are more than twice as likely to use tobacco products as the average American, according to a study presented today at the annual meeting of the American College of Chest Physicians.

In a survey of 408 Marines and sailors, Dr. Michael A. Wilson found 64% used some form of tobacco: 52% smoked cigarettes, 36% used smokeless tobacco and 24% used both. In contrast, the national average for tobacco use is 29.6%. Wilson found the rate of tobacco use is higher now among U.S. troops in Iraq than was found in a 2004 survey of troops returning from the war.

Tobacco use was clearly linked to military service. About half of those surveyed said they had never used tobacco products before joining the military. Eighty percent of the smokers said that being in the military had increased their use while 72% stated that being deployed to Iraq had increased their smoking. Smokeless-tobacco users also said being in the military and being in Iraq increased their usage. Overall, 74% of the troops who use tobacco said they wanted to quit.

Some controversy has surrounded the military's efforts to discourage tobacco use. Smoking among the troops has always been linked with deployment to foreign lands, but much more is known today about the health hazards of smoking, said Wilson, who is stationed with the U.S. Navy, 3rd Battalion, 23rd Marine Regiment, 4th Marine Division, New Orleans.

"There is a culture of acceptance about tobacco in the military. It's embraced by the leadership. A lot of the leadership use tobacco. They learned it from the people they trained with, and it gets passed on."

Wilson conducted the survey while stationed in Iraq and said that troops told him they used tobacco for a variety of reasons: peer pressure, to emulate leaders they admire, boredom, stress relief and to help them stay awake. But, he said, tobacco use is likely to have a greater negative impact to the long-term health of Iraq War veterans than combat-related injuries. The cost of care for troops with tobacco-related health problems will also soar for both the VA and U.S. healthcare systems.

The Defense Department recently launched a virtual anti-smoking campaign targeting enlisted personnel between ages 18 and 25 called "Quit Tobacco, Make Everyone Proud." The Department of Veterans Affairs also has a website on smoking cessation. But more effort should be spent to discourage tobacco use among newly enlisted troops and to discourage smoking in the war zone, Wilson said in an interview with The Times.

"My point is that we have to get them ready to survive Iraq and survive beyond Iraq. Everyone realizes this is a problem. But you need the leadership on a macro level, from the general on down, to the micro level, to get on board because that is who the kids really look up to."

* In a follow-up interview and e-mail, Dr. Wilson said he wanted to make clear that he conducted this study on his own and that the views expressed regarding this study are his own opinions. He is not a spokesman for the U.S. Navy, the U.S. Marine Corps, nor the Department of Defense and his views and opinions do not represent theirs. He is speaking only for himself and his study as a pulmonary and critical care physician and fellow in the American College of Chest Physicians and not as a Lt. Commander in the U.S. Navy Reserve.

-- Shari Roan

Photo credit: Roslan Rahman/AFP/Getty Images