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Am J Public Health. 2010 Jul;100(7):1166-73. doi: 10.2105/AJPH.2009.179846. Epub 2010 May 13.

"Willful misconduct": how the US government prevented tobacco-disabled veterans from obtaining disability pensions.

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  • 1Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, CA 94118, USA.


In this descriptive case study, we analyze the unsuccessful struggle to access disability pensions by veterans sickened by tobacco use begun during service. Drawing on tobacco industry documents and other material, we show how the US government, tobacco industry, and veterans' organizations each took inconsistent positions to protect their interests. Congress and Department of Veterans Affairs leadership, concerned about costs, characterized veterans' smoking as "willful misconduct," thereby contradicting the government's position in a federal lawsuit that tobacco companies addicted smokers. Veterans' groups supported the pensions, despite previously defending smoking as a "right." The tobacco industry wavered, fearing liability. Securing pensions was complicated by the notion that smoking is primarily a personal choice. The US government should compensate veterans fairly and should abolish military practices that encourage tobacco addiction.

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