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Stewart K, Ono SS, Paez MB, Cunningham CL, Holman JE, Katz DA. Smoke Shack(les): Cultural Barriers to Smoking Cessation in VA Hospitals. Poster session presented at: American Anthropological Association Annual Meeting; 2013 Nov 21; Chicago, IL.
Smoking remains the leading preventable cause of death in the US, accounting for approximately 1 of every 5 deaths (420,000 people) each year. The burden of tobacco-related illnesses in the US Veterans Administration (VA) population is particularly high, and the prevalence of smoking is estimated to be 21-40% higher in veterans than in the general population. The Department of Veterans Affairs is committed to tackling this public health priority through implementation of smoking cessation programs and services throughout its integrated healthcare system nationwide. These VA smoking cessation programs exist paradoxically with Congressional actions that officially sanctioned tobacco use in VA hospitals; specifically, the Veterans Health Care Act of 1992 requires VA facilities to provide public smoking areas, or "smoke shacks," for veterans and hospital staff. This poster presentation examines the cultural challenges to implementing a nurse-initiated inpatient smoking cessation intervention in a multi-site VA study. Focusing on institutional policies, notions of the "veteran's right to smoke," and stereotypes of veterans' tobacco use, our findings reinforce and build upon Smith and colleagues' (2012) concept of "tobacco exceptionalism," or the idea that effective smoking cessation policy cannot be achieved in VA, because of tobacco's particular history and cultural relationship with the U.S. military and its veterans .This paper argues that VA smoking cessation initiatives must directly address the cultural and social role that tobacco use plays in veterans' and VA hospital staffs relationship to smoking.
