High tobacco use prevalence with significant regional and sex differences in smokeless tobacco use among Western Alaska Native people: the WATCH study

Koller, Kathryn R.; Flanagan, Christie A.; Day, Gretchen; Patten, Christi A.; Umans, Jason G.; Austin, Melissa A.; Hopkins, Scarlett E.; Raindl, Cheryl; Boyer, Bert B.

doi:10.1080/22423982.2017.1398009

Cited by 8 publications

(11 citation statements)

References 38 publications

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“…Dual tobacco use in our sample was more common among younger than older adults and among males than females. While prior research has identified younger age and gender in association with dual tobacco product use 11,12 , a study of Western Alaska Native people found greater dual use among females than males, with particular high prevalence of Iq'mik use among the women in their sample 12 . Differences in findings by gender may be due to regional differences in tobacco product use.…”

Section: Discussionmentioning

confidence: 95%

“…Notably, 49.3% of Alaska Native adults in the Norton Sound region of Alaska smoke cigarettes compared to 39.0% among Alaska Native adults in Alaska's southwest Yukon-Kuskokwim region 7 ; whereas smokeless tobacco use prevalence in Norton Sound is lower (10.4%) than that in the Yukon-Kuskokwim region (37.5%) 9 . Among all adults in Alaska who smoke, 10% report dual tobacco product use 8 , while estimates of dual use among Alaska Native people who smoke range from 3.0% to 11.0%, differing by region and demographic characteristics [10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

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Cultural and demographic correlates of dual tobacco use in a sample of Alaska Native adults who smoke cigarettes

Epperson¹,

Crouch²,

Skan³

et al. 2020

Tob. Induc. Dis.

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INTRODUCTION Approximately 9 million American adults use two or more tobacco products regularly, referred to as dual or poly tobacco users. In Alaska, where tobacco is not native, approximately 20% of the population smokes cigarettes, and among smokers, 10% use two or more tobacco products. Previous research suggests that dual tobacco product use may be especially high among Alaska Native people. The current study examined cultural and demographic characteristics associated with dual tobacco use. METHODS Alaska Native adults reporting daily smoking and identified with high blood pressure or cholesterol were recruited in the Norton Sound region of Alaska between 2015-2019 as part of a treatment trial targeting cardiovascular disease risk factors. Participants reported their tribal group, level of identification with their Alaska Native heritage, speaking of their tribal language, basic demographic characteristics, and past 30-day use of tobacco products in addition to smoking cigarettes. RESULTS Participants (n=299) were 48.5% female and identified as Yup'ik (31.1%), Inupiat (60.5%), and other or multiple tribal group(s) (8.4%). Most participants (85.3%) strongly identified with their Alaska Native heritage. Past 30-day dual tobacco use was reported by 10.0%, specifically 9.0% chew/snuff, 1.3% e-cigarettes, and 0.7% Iq'mik. Multivariate regression models indicated that dual tobacco use was more likely among men (OR=3.35; 95% CI: 1.30-8.64), younger participants (OR range: 10.97-12.35; 95% CI: 2.33-57.86), those identifying as Yup'ik (OR=2.86; 95% CI: 1.13-7.19), and those who identified very little or not at all with their Alaska Native heritage (OR=2.98; 95% CI: 1.14-7.77). CONCLUSIONS Young men identifying as Yup'ik were more likely to use dual forms of tobacco. Stronger identification with one's Alaska Native heritage was associated with lower risk of dual tobacco use. The findings highlight cultural and demographic factors for further consideration and attention in tobacco cessation treatment interventions.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Cultural and demographic correlates of dual tobacco use in a sample of Alaska Native adults who smoke cigarettes

Epperson¹,

Crouch²,

Skan³

et al. 2020

Tob. Induc. Dis.

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“…The use of tobacco among pregnant and nursing mothers is a ubiquitous and hazardous problem worldwide and it is becoming increasingly recognised that these effects are not limited to affecting the health of the mother but also the foetus and child. The predominant source of tobacco is cigarette smoking, but chewing tobacco is more frequent among fertile women in some regions, for example India and Alaska . Other sources of nicotine, such as e‐cigarettes, waterpipes and smokeless tobacco, are an increasing problem among pregnant women in the USA .…”

Section: Discussionmentioning

confidence: 99%

Snus users had high levels of nicotine, cotinine and 3‐hydroxycotinine in their breastmilk, and the clearance was slower than in smoking mothers

et al. 2018

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Aim Using snus, an oral moist tobacco, has increased among pregnant women in Sweden, the only European Union country where sales are legal. This study evaluated whether snus generated similar concentrations of nicotine and its metabolites in breastmilk to cigarette smoking. Methods We analysed 49 breastmilk samples from 33 nursing mother – 13 snus users, six cigarette smokers and 14 controls – for concentrations of nicotine, cotinine and 3‐hydroxycotinine. The mothers were recruited at antenatal clinics in Sweden from 2007 to 2012. Results The median nicotine concentration in breastmilk of the snus users was 38.7 ng/mL (0–137) versus 24.0 ng/mL (0–56) in smokers, with median cotinine levels of 327.6 ng/mL (37–958) versus 164.4 ng/mL and median 3‐hydroxycotinine levels of 202.7 ng/mL (28–452) versus 112.4 (0–231), respectively. Nicotine was still detected in the breastmilk of eight of the 13 snus users after abstaining from tobacco for a median duration of 11 hours (0.6–12.5), while the breastmilk of the smokers was nicotine‐free after four hours’ abstinence. Conclusion Snus users had high levels of nicotine and metabolites in their breastmilk and nicotine was found even after 12.5 hours of abstinence.

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“…The data set is comprised of three population-based studies initiated in two adjacent western Alaska regions during 2000–2004: the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study ( Howard et al, 2005 ) based in the Norton Sound region, and the Centers for Alaska Native Health Research (CANHR) ( Mohatt et al, 2007 ) and Education and Research Towards Health (EARTH) ( Slattery et al, 2007 ) studies based in the Yukon-Kuskokwim Delta (Y-K) region. All self-reported tobacco use data were either combined directly or harmonized and redefined to incorporate slight differences in collection methods, questions, and/or response options, as described in Koller et al (2017) . The consolidated data set provides a unique opportunity to study age of tobacco initiation among AN people living in these two rural western Alaska regions.…”

Section: Methodsmentioning

confidence: 99%

Age of initiation of cigarette smoking and smokeless tobacco use among western Alaska Native people: Secondary analysis of the WATCH study

Patten

Koller

Flanagan

et al. 2019

Addictive Behaviors Reports

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Objective This study examined self-reported age of tobacco initiation (cigarette smoking and smokeless tobacco [ST] use) and explored potential sex and generational group influences on tobacco use onset among Alaska Native (AN) adult ever tobacco users. Methods Secondary analysis of consolidated data from the Western Alaska Tribal Collaborative for Health (WATCH) study comprised 2800 AN adult ever tobacco users (1490 women, 1310 men; mean age = 39.2 years) from two rural western Alaska regions. ST use data were limited to one region. Logistic regression was used to examine potential sex and generational group (age 18–29, 30–49, ≥50) effects on initiation at ≤13 years of age. Results Thirty-seven percent of the sample reported using any tobacco product by age 13 years. Initiation of any ST use by age 13 was greater than for cigarette smoking (52.7% vs. 18.2%), and women were more likely than men to report initiation of any ST use at ≤13 years (52.6% vs. 38.4%). Nearly one-third of ever smokers (31%) initiated in young adulthood (ages 18–29). For ST use, logistic regression analyses revealed significant sex differences (women more likely to initiate by 13 years of age than men) and generational group effects with younger and middle age groups more likely to report initiation ≤13 years compared to the eldest participants. For smoking, no sex differences were observed but the youngest generational group was more likely to report initiation by age 13 compared to the eldest group. Conclusions Earlier age of tobacco initiation is found among younger generations of AN people. Findings highlight the need to focus prevention efforts on initiation of smoking in young adulthood and uptake of ST use among girls.

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High tobacco use prevalence with significant regional and sex differences in smokeless tobacco use among Western Alaska Native people: the WATCH study

Cited by 8 publications

References 38 publications

Cultural and demographic correlates of dual tobacco use in a sample of Alaska Native adults who smoke cigarettes

Cultural and demographic correlates of dual tobacco use in a sample of Alaska Native adults who smoke cigarettes

Snus users had high levels of nicotine, cotinine and 3‐hydroxycotinine in their breastmilk, and the clearance was slower than in smoking mothers

Age of initiation of cigarette smoking and smokeless tobacco use among western Alaska Native people: Secondary analysis of the WATCH study

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