Three improvised bombs exploded last Easter outside a Baghdad government building, and Sgt. 1st Class Malcolm Russell, a California Army reservist deployed in Iraq, was on high alert, his adrenaline pumping.
When calm finally arrived, Russell reached for a pack of smokes, lit up and inhaled. "I'll never forget that drag, with the hair-raising moments we had. It brought down the stress," he said.
Russell, 34, has lived the horrors of war, but it is his addiction to cigarettes, he said, that has been the toughest battle of all.
When it comes to quitting, "I'm trying to win the war. Sometimes it feels like I'm losing the battle," said Russell, who is back home and, two weeks ago, began a smoking cessation class at Mercy General Hospital in Sacramento, Calif., where he oversees security.
The U.S. military has vowed to join the national fight against smoking, saying it is stepping up its efforts to help military personnel kick their tobacco habits.
Earlier this month, the Navy banned smoking inside submarines. It was the latest sign of a cultural sea change within the U.S. armed services after years of condoning the cigarette addictions of generations of enlisted men and women.
Until the Vietnam War, cigarettes were part of military meal rations: a few smokes served with green tins containing breakfast, lunch or dinner.
These days, the anti-smoking message is plastered across bases and websites that urge the country's 2.2 million warriors to battle their cravings for tobacco, even offering online poker and video games to help soldiers ward off cravings for cigarettes.
Last June, the government's health plan for military families, TRICARE, launched a telephone help line to dispense anti-smoking advice and counseling.
Under pressure from public health officials and anti-tobacco forces, who say smoking drains military budgets and undermines combat readiness, the Department of Defense has vowed it will eventually go tobacco-free. But the Pentagon has yet to say when.
"There's been a long history of the tobacco industry integrating itself in the culture of the military," said Dr. Darryl Hunter, a radiation oncologist who treated military personnel, many of them smokers, for nine years at Travis Air Force Base in California before going to work for Kaiser Permanente.
"Tobacco is the single largest cause of loss of life and health-related expenditures," said Hunter, who is also an Air Force reservist.
In 2006, military hospitals provided $564 million in services for tobacco-related conditions. The Department of Veterans Affairs spent more than $5 billion in 2008 to treat pulmonary disease, much of it traced to smoking.
While the smoking rate among military personnel has plunged over the years, from 51 percent in 1980 to 30 percent today, it remains at least 10 percent higher than that of civilians.
The proportion of smokers is even higher among military personnel deployed overseas, particularly to such volatile regions as Iraq and Afghanistan, where cigarettes help relieve the stresses of combat and the tedium of duty.
In 2007, the departments of Defense and Veterans Affairs asked the national Institute of Medicine to suggest ways to reduce tobacco use among the enlisted and veterans.
The result was a 2009 report that urged the U.S. military to take the war on tobacco more seriously and produce a comprehensive strategy to curb the use of cigarettes, chew and other tobacco products.
The Navy responded in April by announcing a ban on smoking in submarines.
"Despite our atmosphere purification technology, there are unacceptable levels of secondhand smoke in the atmosphere of a submerged submarine," Vice Admiral John Donnelly said last year.
Dr. Michael Fiore, a former major in the U.S. Army and director of the Center for Tobacco Research and Intervention at the University of Wisconsin, acknowledged the military's progress but said it needs to do more.
"Veterans who smoke survive the battlefield," he said, "only to come back home and die from disease, such as lung cancer, heart attacks, strokes, emphysema -- the list goes on."
(E-mail the Sacramento Bee's Bobby Caina Calvan at bcalvan(at)sacbee.com)
(Distributed by Scripps Howard News Service, www.scrippsnews.com.)