Smokers Can Have a Smoke: The Challenge of Reducing Smoking Initiation Among New Recruits

SMOKERS CAN HAVE A SMOKE: THE CHALLENGE OF REDUCING SMOKING INITIATION AMONG NEW RECRUITS

By J. Gradwell

“Smokers can have a smoke”. Everyone who has marched out of Waiouru will remember these words. Called out between the long classes, short meals and inevitable “thrashings” (the better known term for corrective training), it is an army phrase just as familiar to new recruits as the words “corridor”, and “lower… raise”. When instructors call it out, a large white cloud will emerge from desperate recruits looking to get their nicotine fix. This is seen as normal, and staff and recruits alike seem to expect it. However, as that recruit or officer cadet course continues, some disturbing trends inevitably emerge.

When I started recruit training in 2019, my platoon had approximately five smokers (including vapers). By the time I finished it, that had grown to 15. Similar growth in smoker numbers occurred in the other platoons. Some years later, when I attended Officer Cadet School, the same pattern emerged. On both occasions, it seemed to follow like this:

1. First, the existing smokers start smoking more
2. Then they are joined by former smokers who relapse
3. Next, they are followed by young people who, while on recruit course, take up smoking for the first time.
4. Finally, after a week in the field, the business savvy non-smokers get involved. At this point, the smokers are running low. They approach specific non-smokers, who have acquired “exploitation cigarettes” for this specific purpose. These cigarettes were purchased for $35 at the Waiouru Four Square. However, in the field, they are on-sold to desperate smokers for as high as $75.

Incentives and Disincentives

In the past few decades, New Zealand’s efforts to reduce smoking have been mostly successful. In 1983, one in three Kiwis were regular smokers.[1] Today it is one in nine.[2] This has been a result of a huge array of initiatives including:

• Restrictions on where one can smoke (forcing smokers to take the effort of moving to isolated locations to have a puff)
• Extensive anti-smoking advertising
• Tobacco taxes which drastically increase costs
• A ban on tobacco advertising
• Graphic warning labels on cigarettes

These initiatives can best be understood through the lens of behavioural economics. This subfield of economics is focused on incentives and how they inform decisions in different environments. While normative economic theories tend to focus on matters like taxation and interest rates, behavioural economics has proven useful for explaining human behaviour that would initially seem to be economically irrational.[3] For example, it can answer questions such as:

1. Why would someone in New York become a crack cocaine dealer and endure a 25% risk of death on the job, when crack dealers only earn an average of $3 per hour? The same reason many aspiring young actresses find themselves working underpaid roles as extras in Hollywood – Because it is a pathway to one of the only high-status positions that lower class, uneducated inner-city youths see themselves as rising to – as boss of a crack gang. [4]
2. Why do parents from lower socio-economic groups inflict names like Mercedes, Bentley or Chardonnay upon their children? Because these names were originally used by a small number of wealthy families. Parents from lower socio-economic groups proceeded to copy the names as they were associated with wealth and aspiration. This in turn lead to an overabundance of children from lower income families called chardonnay and the wealthy families ceasing to give their children these names. [5]
3. Why are more parents willing to be late when picking up their children up from school when there is a $3 fine, as opposed to no fine? Because it offers the opportunity to eliminate the guilt of arriving late for only $3, which is too low to provide a significant disincentive. [6]

When it comes to understanding smoking initiation in Waiouru, behavioural economics is important. This is because it provides an insight into what incentives and disincentives exist that encourage recruits to do it. While existing smokers are often addicted, and so respond less to incentives and disincentives, non-smokers are not – and they are the focus of this paper.

The incentives and disincentives in normal society, and even the normal army, have done well to reduce smoking. However, at The Army Depot and Officer Cadet School in Waiouru, those incentives are flipped on their heads. This inadvertently means that in the formative training environment, recruits are indirectly encouraged to smoke.

Why Recruits Take Up Smoking

Age, education levels and socio-economic backgrounds are strong predictors of whether someone will take up smoking. [7] The challenge is that recruits at Waiouru often sit in the groups of these categories most likely to smoke. To ensure we get fit, healthy individuals who can be easily socialised and moulded into the military environment, the army recruits most of its people when they are young and without much post-secondary school life experience. [8][9]

However, the age and impressionability of recruits means they are also are less likely to seriously be deterred by smoking’s long-term effects. This in turn, can make recruits much more accepting of smoking than the general population (particularly if they came from a family background or friend group where others smoke, as many do).  [10]

This provides some insight into why so many recruits smoke. However, these factors are not something the Army can control. Instead, they should serve as an insight and an impetus for why the army must make greater efforts to reduce smoking than normal workplaces should.

Smoking is associated with stress and pressure. Indeed, one of the key reasons people from lower socio-economic backgrounds show higher rates of nicotine dependence, is because their lives are marked by greater stress and pressure. [11] Despite evidence that smoking increases stress,[12] it is nonetheless often perceived as something that can reduce it. Someone with $80 in their account, an uncertain job, not much food in the fridge and upcoming hire purchase payments is likely to be more stressed than their middle-class counterpart with a $2000 rainy day fund, a stable job and no crippling debts. Because of this, the first person is much more likely to be attracted to the allure of the cigarette than the second. [13]

Poverty is hard and stressful, and so is Waiouru. When recruits and officer cadets alike march in, they are put through a physically and psychologically intensive process. Heads are shaved, privacy is denied, and the use of first names is prohibited.  Diet, movement, contact with the outside world and routine is tightly controlled. Recruits are likewise subjected to an intense physical workload. [14]

Overall, this process serves the purpose of re-socialising recruits so they can operate in a military environment. Individual identities are supressed and subsumed in favour of the collective identity. This process is important, and unlikely to change anytime soon. However, it does have unintended effects on recruit’s willingness to take up smoking. Amid this tough environment, one of the few decompression and anti-boredom mechanism available to recruits is smoking. Compare that to the common ways unavailable to recruits in which the average 20 year old civilian will decompress:

• Gaming
• Web surfing or chatting to friends on their phones
• Eating or drinking what they want
• Going to the gym and performing their own workouts at their own pace
• Going for a walk
• Intimacy with partners

Here, behavioural economics comes into play. During a break or at the end of a long day, recruits desire something that will help them decompress. This is perfectly logical, as it is what helps them through the course. However, their access to standard decompression tools is restricted. Therefore, non-smoking recruits (for whom addiction is not a factor), are inadvertently incentivised to take up smoking as the only available thing that can serve this purpose.

This incentive is combined with the relative absence of what is usually a powerful disincentive that serves to reduce smoking – the cost. For most civilians, the thought of spending $35 on each packet of cigarettes is a powerful incentive to not smoke. After all, one could get three big mac combos for the same price. However, a recruit can’t do that. Instead, they are receiving around $1200 into their accounts each fortnight. Instead of spending it on rent, food, power and fuel, a recruit has few options to spend it on anything more than razors, plasters and the only sweets they won’t get in trouble for eating – cough lollies.

Most civilian smokers come from lower socio-economic backgrounds, where $35 per pack is likely to provide a powerful disincentive to smoking. However recruits, despite earning less than minimum wage, have plenty of money to spend. Therefore, A few $35 packs of cigarettes is hardly going to make a dent, meaning that for recruits, the cost disincentives to stop smokers, dont apply. While it reappears once they depart Waiouru, by that point, many new soldiers have already developed an addition that will prove extremely difficult to kick. Simply put:

1. Recruits predominantly fall into the groups most likely to smoke
2. Recruits have a powerful incentive to smoke (for a lack of normal alternatives amid a stressful, high pressure environment)
3. The cost disincentive that serves to prevent smoking does not apply to recruits.

Together, these factors mix to provide a potent cocktail, leading to absurd numbers of recruits taking up smoking on training, where they otherwise wouldn’t on civilian street.

The Army’s Long-Term Interest in Reducing Smoking

Some years ago, the NZDF committed to smoke free targets. The reason for this was very simple – Smoking is a key contributor to serious health conditions. [15] Everyone knowns about the relationship of smoking to long term respiratory conditions and lung cancer.[16] This may not be immediately relevant to new recruits, who don’t always think 20 years in advance, but the army certainly has an interest in it. This is because a small number of those recruits will spend the rest of their careers in the army, and will go on to reach senior commissioned or non-commissioned ranks. Generally, these ranks take around 20 years to reach. This means they come at the age where the long-term effects of smoking begin to make themselves felt. When diagnosed with cancer or a long-term respiratory condition, one ceases to be deployable. Effectively this means that smoking limits the potential pool of future senior personnel, something that the army has an interest in avoiding.

The Army’s Short-Term Interest in Reducing Smoking

The army also has a shorter-term interest in stopping recruits from smoking. This is because, smoking serves to reduce endurance and exacerbate other illnesses and injuries. [17] [18] Effectively, smoking can mean that a sick or injured person could be off work for ten days rather than five if they were a non-smoker. It also means they would not reach their full fitness potential. This is particularly relevant to smoking on recruit courses as it is a serious consideration for the lower ranking enlisted and officers, who’s jobs demand that they must be fit. This is in contrast to senior officers and senior NCOs, whose roles have less of a physical focus. Overall, this means is that the army has an immediate, short term interest in reducing smoking rates among recruits – one that goes beyond any legal obligations. While the NZDF has instituted smoking reduction targets and introduced smoking cessation care for all who request it, [19] that should not distract from the fact that large numbers of recruits seem to take up the habit solely due to the military environment. Indeed, that recruits start smoking, when they otherwise wouldn’t in a non-military environment, in spite of existing efforts such as removing cigarettes from hotshots, should exhort the army to do more.

Just Banning Smoking Won’t Work

On both my recruit and officer training, only one NCO refused to accept smoking as a normal part of military life. Tired of seeing soldiers puffing their lungs away, this particular instructor actively encouraged (and still encourages) recruits to quit. Whenever a smoker asked permission for a puff, he would ask them “how old are you?”, When they replied (usually with a figure of 18 to 21), he would respond “F***ing hell”, and tell them “No. Just quit”. This particular Staff Sergeant’s efforts are admirable. Instructors usually use harsh words as a technique to encourage desirable behaviour and build resilience. However, this NCO was the only one using it specifically to spread anti-smoking messages in an environment where none otherwise existed. However, without broader organisational support, this lone NCO’s efforts are unlikely to lead to significant numbers of recruits resisting the urge. While a total ban on smoking during recruit courses might do this, the trade-offs of such a ban would be too high. This is because:

• If instructors were allowed to smoke but recruits were not, it could serve to undermine confidence in their command.
• If instructors were not able to smoke either, it could disincentivise otherwise good NCOs from putting their names forward to be instructors.
• If recruits were not able to smoke, it could dissuade smokers who otherwise would make excellent soldiers, from joining the army in the first place
  • For recruits with an existing addiction, it could also play a role in whether they quit partway through training or not. For example, an article written by a territorial officer referred to an occasion where an addicted recruit chose a cigarette over a phone call to his partner. [20]
• Finally, this approach would provide no buy-in from the recruits, particularly those existing smokers who may have never desired to quit in the first place. This means that those recruits who were forced to quit smoking for the duration of training would be likely to take it up again following graduation.
  • Indeed, in the late 1990s, the US Navy instituted a strict no smoking policy in recruit training. Despite the ban, when they followed up the smokers a year later, only 19% of the initial smokers had not returned to smoking. [21]

A Possible Solution: How Changing Incentives Could Stop Recruits From Deciding to Smoke

Every recruit who smokes on basic training, but didn’t as a civilian, was previously responsive to incentives that stopped them from smoking. However, in Waiouru, the incentives are changed, leading recruits to take up smoking where they otherwise wouldn’t. Based on this understanding, reducing smoking initiation among recruits relies on introducing new incentives and disincentives. Consider the following proposal:

1. On arriving at Waiouru, all recruits are asked to fill out a register indicating whether they are smokers or not, and if they are smokers, if they wish to quit.
2. Smokers are placed on a smokers list, and afforded the privilege of purchasing and smoking cigarettes and vapes.
3. Non-smokers, and those wishing to quit are placed on a non-smokers list, and are afforded different privileges which form an incentive to not smoke.
   • This could be takeaway nights on set days, extra leave days, issued MP3 players with headphones or some other solid incentive that proves more appealing than smoking while not compromising training. This must be a solid incentive, to be received at a specific time and date (so recruits can mentally look forward to it).
   • Smokers cannot share cigarettes or vapes with non-smokers (or anyone else), likewise non-smokers cannot purchase, borrow or ask for cigarettes from anyone else. Anyone who breaches these rules will face charges with clear, standardised punishments – a significant disincentive.
4. Smokers cannot share cigarettes or vapes with non-smokers (or anyone else), likewise non-smokers cannot purchase, borrow or ask for cigarettes from anyone else. Anyone who breaches these rules will face charges with clear, standardised punishments – a significant disincentive.
5. At any point a smoker can, decide to switch to the non-smokers list and will immediately receive those privileges of the non-smokers.
6. No non-smokers will be permitted to switch to the smokers list.
7. No one who switched from the smokers to non-smokers list can switch back without express permission from a senior NCO (at least a Staff Sergeant) or officer (at least Captain). The exception mechanism allows some flexibility to deal with issues of addiction.
8. Recognising the comparatively healthier status of vapes to cigarettes, vapers should be considered a subcategory of the smokers group.
   • When cigarette smokers determine to switch to vapes, they are placed on a cigarette ban (similar to that of non-smokers) and issued with a vape and a supply of vape juice. This can happen at any time, including in the field.
   • However, while vaping is preferable to smoking, non-smoking remains massively preferable to vaping. Vapers should still be encouraged to quit, and would not be granted the same privileges as non-smokers.

Unlike a total ban, this approach offers the opportunity to gain buy-in from recruits themselves. A forced ban is unlikely to convince anyone to quit smoking in the long term. However, offering recruits a choice between placing one’s name on a smokers list or a non-smokers list means that they get to make the decision themselves – meaning they are much more likely to stick with it.

Currently, those who seek to quit smoking on recruit courses will be issued with nicotine patches but not much else, which is not much of an incentive to quit. With this approach however, the incentives and that lead recruits to smoking could be replaced by ones that will encourage non-smoking.

It is worth noting that this approach to quit smoking is unlikely to lead to a significant drop-in long-term smoking rates among existing smokers. If existing evidence is anything to go by, most people who attempt to quit on recruit training will likely return to smoking later.[22] Instead its focus is on preventing non-smokers from taking up the habit. Further by introducing this mechanism, it offers a level of fairness and integrity to the system that wouldn’t otherwise exist (in that recruits are given a choice between the different privileges).

Most new or relapsed smokers do not buy their first cigarette, but are instead supplied it by a peer. By banning the supply and sharing of cigarettes, as well as their purchase by declared non-smokers this approach eliminates this problem. Instead, it introduces a significant disincentive (a charge with a specified punishment) for non-smokers to take up smoking. This same disincentive, prohibiting non-smokers from sharing their privileges, would support the system’s integrity.

At present, the army offers no specific incentives for recruits to not take up smoking beyond those which exist in normal society. However, by offering clear positive incentives (to go on the non-smokers list), this could potentially prevent recruits (particularly former smokers) from deciding to put their names on the smokers list “just in case they want one later”. Likewise, by instantly providing those benefits to anyone who chooses to quit smoking, the allure of seeing one’s peers with the non-smoking incentives may prove just enough to get some smokers to cease – even if the act of them quitting is unlikely to last.

The system does create two classes of recruits, which may pose the risk of undermining collective identities. However, it is important to note:

1. This class divide only exists for very short, specific points in the course (namely, when smokers are smoking, or when non-smokers are receiving their privileges)
2. Recruits have a choice as to which list they go on, and they can move to the non-smokers list at any time
3. This divide isn’t too far from the existing system, where smokers congregate in their own groups while smoking, away from the non-smokers
4. Formal divides already exist on recruit courses – such as between those confined to barracks and those not
5. Informal divides between smokers and non-smokers already exist on recruit courses
6. There are no rules prohibiting discrimination on the basis of whether one is a smoker.

Conclusion

On account of who the army enlists, it is inevitable that new recruits will be particularly susceptible to smoking, and less likely to consider its long-term effects. In spite of this, it is important both for the short and long-term strength of the army, that it encourages recruits to reject smoking. When people make the decision to start smoking, they consider different factors. Here, behavioural economics offers a useful approach for understanding the decision to smoke as a matter of incentives and disincentives. In civilian life, young people choose not to smoke because of a complex system of incentives and disincentives. When those same people march into Waiouru – the incentives to smoke are stronger, and the disincentives are weaker. This is why so many recruits take up smoking. This is an issue, and one that needs thinking and addressing. One possible solution is that by introducing new incentives and disincentives to not smoke, the number of recruits who take up smoking may be reduced. This can take the form of establishing formal smokers and non-smokers lists of recruits, offering privileges (or incentives) to non-smokers and disincentivising the sharing of cigarettes through the threat of charges. At present, the Waiouru environment indirectly encourages recruits to take up smoking. While this approach is unlikely to cause many existing smokers to permanently quit, it should mitigate the effects of that environment, and reduce smoking initiation among new recruits.

Note: Prior to commissioning, the author served as an advisor to the opposition on the most recent smoking and vaping laws.

 

Footnotes:

[1] “Smokefree Facts & Figures.” Health Promotion Agency, December 24, 2021. https://www.smokefree.org.nz/smoking-its-effects/facts-figures.

[2] Ibid.

[3] Levitt, Steven D., and Stephen J. Dubner. Freakonomics. B DE BOOKS, 2014.

[4] Ibid.

[5] Ibid.

[6] Ibid.

[7] O’Loughlin, Jennifer, Erin K. O’Loughlin, Robert J. Wellman, Marie-Pierre Sylvestre, Erika N. Dugas, Miguel Chagnon, Hartley Dutczak, Johanne Laguë, and Jennifer J. McGrath. “Predictors of cigarette smoking initiation in early, middle, and late adolescence.” Journal of Adolescent Health 61, no. 3 (2017): 363-370.

[8] Assessing the Quality of Recruit Training in the NZDF. Report. October 2015. https://www.defence.govt.nz/assets/Uploads/a9908e2d06/evaluation-report-recruit-training.pdf

[9] DFO (A) Vol 7, Chapter 5, Section 4: Physical Education and Recreational Training. New Zealand Army. October 2021.

[10] Slovic, Paul. “What does it mean to know a cumulative risk? Adolescents’ perceptions of short‐term and long‐term consequences of smoking.” Journal of behavioral decision making 13, no. 2 (2000): 259-266.

[11] Hobkirk, Andréa L., Nicolle M. Krebs, and Joshua E. Muscat. “Income as a moderator of psychological stress and nicotine dependence among adult smokers.” Addictive behaviors 84 (2018): 215-223.

[12] Smoking and mental health. Mental Health Foundation. (2021, July 20). Retrieved February 8, 2022, from https://www.mentalhealth.org.uk/a-to-z/s/smoking-and-mental-health#:~:text=Smoking%20and%20stress,it%20reduces%20stress%20and%20anxiety.

[13] Stewart, Miriam J., Lorraine Greaves, Kaysi Eastlick Kushner, Nicole L. Letourneau, Denise L. Spitzer, and Madeline Boscoe. “Where there is smoke, there is stress: low-income women identify support needs and preferences for smoking reduction.” Health care for women international 32, no. 5 (2011): 359-383.

[14] McGurk, Dennis, Dave I. Cotting, Thomas W. Britt, and Amy B. Adler. “Joining the Ranks: The Role of Indoctrination in Transforming Civilians to Service Members.” (2006).

[15] “Health Policy: DS-IMP-HPM-001: Provision of

Smoking Cessation Care.” NZDF. July 3 2020. Accessed February 8 2022.

[16] “Health Effects of Tobaco.” Centers for Disease Control and Prevention. April 28, 2020. Accessed January 13, 2022. https://www.cdc.gov/tobacco/basic_information/health_effects/index.htm#

[17] Reynolds, Katy L., Heidi A. Heckel, Calvin E. Witt, James W. Martin, Jon A. Pollard, Joseph J. Knapik, and Bruce H. Jones. “Cigarette smoking, physical fitness, and injuries in infantry soldiers.” American journal of preventive medicine 10, no. 3 (1994): 145-150.

[18]  Kung, Chien-Min, Hai-Lung Wang, and Zu-Lin Tseng. “Cigarette smoking exacerbates health problems in young men.” Clinical and Investigative Medicine (2008): E138-E149.

[19] “Health Policy: DS-IMP-HPM-001: Provision of

Smoking Cessation Care”

[20] McKenzie, Peter. “I Was a Coddled University Student. And Then I Joined the Army Reserves.” The Spinoff. November 25, 2018. Accessed January 14, 2022. https://thespinoff.co.nz/society/25-11-2018/i-was-a-coddled-university-student-and-then-i-joined-the-army-reserves.

[21] Brandon, Thomas H., Robert C. Klesges, Jon O. Ebbert, Gerald W. Talcott, Fridtjof Thomas, Karen Leroy, Phyllis A. Richey, and Lauren Colvin. “Preventing smoking initiation or relapse following 8.5 weeks of involuntary smoking abstinence in basic military training: trial design, interventions, and baseline data.” Contemporary clinical trials 38, no. 1 (2014): 28-36.

[22] Ibid.