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Rachael Joyner

Addressing Tobacco and Nicotine Use in Military Settings

Duke-UNC TTS teaching faculty from the Duke Smoking Cessation Program, the UNC Tobacco Treatment Program, and the NC Tobacco Prevention and Control Branch collaborate to help Fort Liberty medical personnel with the task of addressing tobacco and nicotine use in military settings.


by Rachael Joyner

Infographic with statistics about tobacco industry targeting military
The tobacco industry has targeted the military for decades (Truth Initiative)

The Duke-UNC Tobacco Treatment Specialist Training team was featured recently in an article about a training hosted at Fort Liberty Army installation in North Carolina. The two-day training aimed to educate both military and civilian healthcare providers serving at Fort Liberty on the dangers of tobacco use, including e-cigarettes and smokeless nicotine products, and how to provide evidence-based treatment.


Historically the rate of tobacco use among military service members and veterans is higher than that of the general population. The 2020 Report of the Surgeon General reported that 38% of current smokers started after they joined the military. In 2015, the rates of cigarette smoking and smokeless tobacco use for military service members were 13.9% and 12.7%, respectively. For context, the rate of smokeless tobacco use in the general U.S. population at that time was 3.4%.

38% of current smokers in the military began smoking after joining.

LTC Teresa Pearce, director of the Fort Liberty Department of Public Health, shared that results from a 2021 community survey showed that “almost 60 percent of service-member respondents reported current tobacco or vaping use. This increased to 75 percent, when looking at respondents who live in the barracks.”

Smokeless tobacco users by branches of the military (Truth Initiative): 31.9% in the Marine Corps, 20.8% in the Army, 16.9% in the Navy, and 13.3% in the Air Force
Smokeless tobacco users by branches of the military (Truth Initiative)

These statistics underscore the need for targeted tobacco treatment for this population. The Centers for Disease Control and prevention has compiled a list of tobacco cessation resources for military service member and veterans.


With over 40,000 active-duty soldiers, Fort Liberty is the largest Army base in the United States by population. The installation covers 251 square miles and is home to military family members, contractors, retirees, and civilians – a population of over 250,000 people – that has a significant economic impact on the surrounding communities.


To learn more about how to address diverse populations using tobacco, check out one of our upcoming TTS trainings: https://www.dukeunctts.com/programs


To learn more about how Duke-UNC TTS can tailor a training for your installation, please contact our office at cttsprogram@duke.edu or 919-668-5042.


About the Author

Blog post author Rachael Joyner, DNP, FNP-BC, APRN
Rachael Joyner, DNP, FNP-BC, APRN

Rachael Joyner, DNP, FNP-BC, APRN, is a family nurse practitioner with the Duke Smoking Cessation Program. She holds a National Certificate in Tobacco Treatment Practice and received her Doctorate in Nursing Practice from the University of Florida. She loves working collaboratively with patients to help them become tobacco free.

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