Friday, April 28, 2017

Report Recommends Ban On Submarine Smoking

Originally Published July 28, 2009; Last Updated April 28, 2017; Last Republished April 28, 2017:

Our National Academy of Sciences Committee on Smoking Cessation in Military and Veteran Populations; Institute of Medicine is out with a new publication on Combating Tobacco Use in Military and Veteran Populations 2009.
"Recommendation: Tobacco use should be banned on military installations, and in all military aircraft, all surface vehicles, and all ships and submarines."1

Cigarette smoking on a submarine is no trivial matter due to a submarine's closed environment; recirculation of scrubbed atmosphere; smoke aerosol; 3,800 chemicals found in cigarettes2; and harm to our submariners' health3. A submarine's central atmosphere monitoring system (CAMS) continuously samples4 the submarine's atmosphere using infrared spectrometer to measure carbon monoxide and a mass spectrometer to measure oxygen, nitrogen, carbon dioxide, hydrogen, water vapor, and freon5.


Click for larger color cut-out of Los Angeles-class
UPDATED 02/09/2012 The CAMS IIA (manufactured by United Technologies Hamilton Sundstrand) will be retrofitted into active Los Angeles-class, Seawolf-class and Block I and II Virginia-class submarines.   Beginning with Block III Virginia-class submarines the CAMS IIA units will be original installed equipment.

Of course cigarette smoking is not the only source of potentially harmful chemicals on a submarine—other sources include cooking; human body; equipment; power train; weapons systems; batteries; sanitary tanks; air-conditioning; refrigeration systems; and a variety of maintenance and repair activities. ... you have to cook the Cajun blackened red fish slightly different than you would at home—lest you create an atmospheric emergency instead of an epicurean delight!  


Res6:

UPDATED 11/01/2016 NavyMed, Navy & Marine Corps Public Health Center, Tobacco Free Living
UPDATED 04/02/2012 NAP, Scientific Standards for Studies on Modified Risk Tobacco Products

Hopefully, our submarines will not use the modified risk tobacco products having reduced or eliminated cigarette smoking during deployment.
...Smoking is the leading cause of preventable morbidity and mortality in the United States, contributing to approximately 443,000 premature deaths each year nationally(CDC, 2008). Smoking-related disease causes more deaths than alcohol, illicit drug use, homicide, and suicide combined (Mokdad et al., 2004). Another 8.6 million smokers in the United States live with a smoking-attributable illness (CDC, 2009a). In total, tobacco-related mortality amounts to approximately 5.1 million years of potential life lost per year (CDC, 2008). Smoking also imposes enormous costs on the U.S. health care system and economy, with an estimated $193 billion in losses due to health care costs and productivity losses per year (CDC, 2008).
UPDATED 04/02/2012 EHP, New Device Measures Atmospheric Isocyanic Acid

...researchers calculated mainstream cigarette smoke may contain 40–140 ppmv HNCO [isocyanic acid]. Urea is added to cigarettes to enhance flavor.

UPDATED 11/05/2010 CDC, State-Specific Prevalence of Cigarette Smoking and Smokeless Tobacco Use Among Adults --- United States, 2009.

...Several states were identified with high prevalence of both cigarette smoking and smokeless tobacco use. Additionally, co-use of smokeless tobacco among men who smoke cigarettes, a behavior that might hinder successful smoking cessation (5,6), was common in several states..."--CDC Cigarette Smoking and Smokeless Tobacco--

UPDATED 05/13/2010 CDC, Adult Tobacco Survey (ATS). Report includes data collected during February 2003--November 2007.

UPDATED 04/15/2010 When announcing the recent ban on smoking below deck on all navy submarines ComSubFor referenced a 2009 Naval Submarine Medical Research Laboratory (NSMRL) nine submarine secondhand smoke study. However neither NSMRL nor ComSubFor appear to have released the study? Presumably the study was conducted by Gertner et al.?

UPDATED 04/09/2010 CDC, Best Practices for Comprehensive Tobacco Control Programs 2007

UPDATED 01/27/2010 NAP, Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence (2010)

UPDATED 01/27/2010 The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General

NAP, Emergency and Continuous Emergency and Continuous Exposure Limits for Selected Airborne Contaminants, Vol 1

NAP, Emergency and Continuous Exposure Guidance Levels for Selected Submarine Contaminants, Vol 2

Web:  

UPDATED 04/28/2017 NavyMil, Navy Suspends Electronic Nicotine Delivery Systems (ENDS) on Ships, Subs, Aircraft and NavyMil, Tobacco Free Living
UPDATED 11/01/2016 NavyMil, Navy Medicine Encourages Sailors and Marines to Quit Tobacco  and NavyMil, Live Tobacco-Free: The Time Is Now and Wired, This Robot Chain Smokes Cigarettes So Rats [and you] Don't Have To


Until clinical medicine is able to reliably block an individual's molecular addictive pathway(s) related to nicotine, tobacco usage will be a difficult habit to "kick"...but stopping is possible, even if it requires repeated attempts over prolong periods of time.

"There is no safe tobacco product and no safe level of use,"--Dr. Long--

Tobacco smoke has ionizing Polonium 210, which has a half-life of about 138 days, alpha decaying to stable Lead 206. Submariners and others should avoid tobacco smoke as if it were ionizing radiation.

Also, it's worth noting that smoking impairs the molecular mechanisms that routinely repair our intercalated DNA helical base pairs (mutations), which prevents normal cellular DNA replication.

Kudos to the submariners who've endure long periods submerged without smoking!

UPDATED 07/01/2013 LBNL, Berkeley Lab Confirms Thirdhand Smoke Causes DNA Damage

Baleful cigarette weaponry continues to menace, molest, mutate, maim and collaterally kill members of our civil society while our judiciary considers (see below) whether requiring prominent pictograms on "product packaging" is permissible. You can't make this stuff up!

UPDATED 04/12/2012 Thomson Reuters, U.S. appeals court hears case of graphic tobacco ads

Cigarettes have two attributes that distinguish them from most, if not all other products—when used as the manufacturer intends they addict and prematurely kill a significant portion of our citizens.

The lower court judge ruled that our FDA could use increased the taxes or factual information but not graphic images (see below) to discourage smoking. Wonder if the FDA or congress could determine cigarette manufactures lack standing whenever any cigarette user sues them?

Curiously, the lower court logic appears to grant strict scrutiny to commercial speech. Moreover, the logic seems to ignore fact that cigarettes are highly addictive and may not be responsive to higher prices or additional textual information (i.e are required but insufficient to eradicate smoking).

UPDATED 03/30/2012 SMH, Tobacco firms told to come clean

It's amazing that our FDA is only requiring tobacco firms to disclose 20 of the estimated 3,800 chemicals thought to be in cigarettes—guess if the first 20 chemicals kill you the remaining 3,780 are redundant.

In related good news our CDC's recent anti-smoking ad campaign more than doubled the number of calls to 1-800-QUIT-NOW and more than tripled the visits to website www.smokefree.gov.


UPDATED 01/01/2011 NYT, As of Friday, No Fire Down Below.

UPDATED 11/15/2010 NavyMil, Groton Submarines Create Fresh Starts, Prepare for Dec. 31 Smoking Ban.

UPDATED 10/22/2010 NavyMil, Smoking Lamp Grows Dim On Submarines. Twenty-one submarines have already met the tobacco-smoke-free deadline and others are on schedule to beat the deadline. Kudos to our smoking submariners and those helping them to quit this super-addictive, difficult to eliminate habit.

UPDATED 04/08/2010 NavyMil, Smoking To Be Extinguished On Submarines. Commander, Submarine Forces (COMSUBFOR) has announced a total ban on smoking inside all U.S. Navy submarines, effective not later than December 31, 2010.

UPDATED 03/29/2010 NavyTimes, CNO: Smoking ban for subs in the works. The Navy Times article is unclear on how the ban will be implemented, but will likely include significant resources and assistance to help our submariners kick this very addictive and harmful habit. Repeated unsuccessful attempts to quit smoking usually precede successful smoking cessation over an extended period. Perhaps a little intra-inter-submarine competition, rewards, and recognition will help our submariners adopt and maintain a tobacco free (not just cigarette smoking) lifestyle?

UPDATED 02/05/2010 UPI, Individual risk helps smokers quit. Research indicates that giving our submariners that smoke cigarettes specific data from their medical tests indicating impairment to their health will help them quit (e.g. data from their lung capacity tests).

-----notes------

1. This is not the first time an Academy committee has recommended a ban on submarine smoking—clearly the trend is toward encouraging cessation and an eventual ban. Currently submarine smoking is permitted in accordance with SECNAV Instruction 5100.(5) Submarines, July 31, 2008:
"Tobacco-use areas may be designated aboard submarines following the guidance of reference (e) [NAVSEA S9510-AB-ATM-010, Nuclear Powered Submarine Atmosphere Control Manual; Volume 1(U), Rev 2]. These spaces must be well ventilated and not in the vicinity of stationary watch stations. Berthing spaces, messes, lounges, and exercise areas shall not be designated as tobacco use areas. The number of smoking tobacco users authorized to use a designated tobacco use area at one time shall be limited by the clearance capacity of the ventilation system."
Jackman et al. (2004) found that exposure of nonsmokers to secondhand smoke on submarines was minimal during a 10-day deployment (Jackman et al., 2004). Seufert and Kiser (1996), however, found that after 62 hours in a nonventilated submerged submarine the end-expiratory carbon monoxide (EECO)levels of nonsmoking crew members were equal to the initial EECO levels of crew members who smoked suggesting that nonsmokers were exposed to elevated levels of carbon monoxide.

2. Including CO and CO2—each smoked cigarette produces 0.026-0.07 grams of CO (carbon monoxide).

3. The percentage of submariners smoking cigarettes has declined over the last twenty-five years from ranges of 30%-40% to 20%-30%.

A recent survey across a number of submarine crews and patrols found the average self-reporting smoking rate to be 11%. (see Terry L. Thomas et al., "Health of U.S. Navy Submarine Crew During Periods of Isolation". Aviation, Space, and Environmental Medicine, Vol. 74, No. 3, March 2003)

UPDATED 07/28/2009 Commissioned smokers 2.2% (N=1,389); Non-Commissioned smokers 14.4% (N=11,952); Smoking status Unknown 2.6% (N=36) and 2.9% (N=344), respectively.

These low percentages are very encouraging: they are overall much lower than the general smoking population; low among non-commissioned submariners; and very low among commissioned submariners (encouraging directly and indirectly cessation of smoking).

There are some data to suggest that smoking and radiation exposure are augmentative with respect to lung cancer—of course it is well known that each independently cause lung cancer, too.

4. The CAMS samples air from different locations in addition to monitoring the main fan room containing the huge blower. The blower can be configured to intake, exhaust, or recirculate air atmosphere. (as an aside it can also be used to blow air into the ballast tanks!)

5. Other chemicals, substances, and compounds may be monitored using simple techniques such as calibrated color-metric tubes.

6. Post is substantially based on information from these publications—a wealth of information on the topic of submarine atmosphere.

Also Our National Academy of Sciences Committee on Smoking Cessation in Military and Veteran Populations and Institute of Medicine Combating Tobacco Use in Military and Veteran Populations 2009.

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