Nearly 40 percent of Israelis are smokers by the time they finish their compulsory army service, according to a new study.
That is twice as high as the overall national rate and dramatically higher than among American soldiers, according to the study published Monday in the journal Nicotine & Tobacco Research.
Researchers at Tel Aviv University, the Hebrew University of Jerusalem and the University of Haifa conducted the study in cooperation with the Israel Defense Forces' Medical Corps. Data came from nearly 30,000 soldiers between 1987 and 2011.
About 37 percent of Israeli soldiers are smokers when they are discharged, compared to 26 percent of new recruits, the study found -- a 42 percent increase over the course of service.
The researchers behind the study called for the creation of an anti-smoking body in the Israeli army to address the problem.
"The use of tobacco harms IDF soldiers and security in general," the lead author, Dr. Leah Rosen of Tel Aviv University, said in a statement. "The government and the Ministry of Health need to cooperate with the IDF in order to reduce the number of soldiers who start smoking, to encourage soldiers to quit smoking, and to protect non-smokers from exposure to cigarette smoke.
“We should take an example from the United States, which conducted extensive changes to the smoking policy in its military to protect its soldiers and to improve the readiness and performance of its combat units.”
Army service is mandatory for most Israeli Jews and a central part of the national identity. Smoking cigarettes to cope with the boredom and stress is a well-known part of the experience.
The IDF Spokesperson's Unit said in a statement that most people start smoking at age 18, regardless of army service. The army said smoking had decreased in the army, as in Israel, in the "last few years," and pointed to a "range of actions" it had taken against smoking, including offering anti-smoking education, help quitting smoking and enforcing the ban on smoking in public spaces.
"The IDF sees great importance in reducing the number of smokers and the damage induced from smoking, and will continue to work in cooperation with all relevant parties in order to reduce this phenomenon and promote the health of its soldiers," the army said.
In the U.S. military, smoking has plummeted since the first anti-smoking programs were introduced in 1975, but there has been a similar decline among Americans in general. About 24 percent of U.S. soldiers smoked in 2011, according to the Department of Defense, and 15 percent of adults smoked in 2015, according to the Centers for Disease Control.
By comparison, about 20 percent of Israeli adults smoke, Central Bureau of Statistics data shows. The average rate across Europe is even higher.
Although smoking has decreased in Israel in recent decades, the study found no significant change over the years in how many soldiers were smokers when recruited or discharged. The researchers said there is no simple explanation for the disconnect.
Some 18 percent of Israeli soldiers first started lighting up in the army, and 56 percent relapsed. Soldiers with combat profiles were more likely to take up smoking during their service, after adjusting for other factors. Men (40 percent) were more likely than women (32 percent) to be smokers when they were discharged from the army, although the increase in smoking during service was similar between the sexes.
Because 50 percent to 65 percent of smokers die early from smoking-related causes, the increase in smoking during army service imposes huge costs on Israeli society. The good news, the researchers said, was that the army is uniquely capable of creating social change.
They recommended establishing a special anti-smoking program that would target former smokers and the types of soldiers who tend to end up serving in combat units, where smoking is more common. Their other suggestions included enforcing smoking bans in public areas, preventing soldiers from getting free or cheap cigarettes, offering treatment for tobacco addiction tailored to army life, and monitoring smoking on an individual and army-wide basis.
Commanders should set a non-smoking example, they said, particularly in combat units and during operations.