Iqmik: A Form of Smokeless Tobacco Used Among Alaska Natives

Renner, Caroline C.; Enoch, Carrie; Patten, Christi A.; Ebbert, Jon O.; Hurt, R. Douglas; Moyer, Thomas P.; Provost, Ellen

doi:10.5993/ajhb.29.6.13

Cited by 39 publications

(31 citation statements)

References 12 publications

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“…Unique to the Alaska Native people of this region is the use of a homemade form of smokeless tobacco (ST) known as iqmik, a mixture of tobacco leaves and fungus ash (Renner, Enoch, et al, 2005). However, iqmik and other tobacco products are not used for religious or ceremonial reasons (Blanchette, Renner, Held, Enoch, & Angstman, 2002).…”

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confidence: 99%

Focus Groups of Alaska Native Adolescent Tobacco Users: Preferences for Tobacco Cessation Interventions and Barriers to Participation

et al. 2007

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Tobacco cessation interventions developed for Alaska Native adolescents do not exist. This study employed focus group methodology to explore preferences for tobacco cessation interventions and barriers to participation among 49 Alaska Natives (61% female) with a mean age of 14.6 (SD = 1.6) who resided in western Alaska. Using content analysis, themes from the 12 focus groups were found to be consistent across village, gender, and age groups. Program location or site (e.g., away from the village, hunting, fishing), a group-based format, and inclusion of medication and personal stories were reported to be important attributes of cessation programs. Motivators to quit tobacco were the perceived adverse health effects of tobacco, improved self-image and appearance, and the potential to be a future role model as a non-tobacco user for family and friends. Parents were perceived as potentially supportive to the adolescent in quitting tobacco. The findings will be used to develop tobacco cessation programs for Alaska Native youth.

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Focus Groups of Alaska Native Adolescent Tobacco Users: Preferences for Tobacco Cessation Interventions and Barriers to Participation

et al. 2007

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“…Many surveys are conducted by phone and may lack representation from AN people in remote areas due to language barriers and lack of telephones (ADHSS, 2007;Renner et al, 2005). The Alaska Education and Research Towards Health (EARTH) study allowed participants to hear and answer questions in Yup'ik and included urban, rural, and frontier sites.…”

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Tobacco use among Alaska Native people in the EARTH study

Smith

Ferucci

Dillard

et al. 2010

Nicotine & Tobacco Research

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“…The addition of ash raises the pH of the tobacco and increases the amount of free (unionized) nicotine available for absorption. 5,26 Therefore, self-report of CPD smoked or cans per week of ST used may not adequately reflect individual nicotine or other chemical exposure. The correlation between maternal cotinine and infant NNAL, despite reduced tobacco consumption, legitimizes concerns over fetal exposure to carcinogens.…”

Section: Discussionmentioning

confidence: 99%

“…The elevated ST prevalence among AN women is driven primarily by the common use of iqmik, a homemade chewing tobacco made with tobacco leaves and ash. 4,5 The ash is produced from burning willow bushes, alder, driftwood, or fungus (punk), which grows on birch trees. 5 In addition to the high prevalence of tobacco use during pregnancy, AN women have lower spontaneous smoking quit rates and higher relapse rates postpartum than non-Native Alaskan women.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 The ash is produced from burning willow bushes, alder, driftwood, or fungus (punk), which grows on birch trees. 5 In addition to the high prevalence of tobacco use during pregnancy, AN women have lower spontaneous smoking quit rates and higher relapse rates postpartum than non-Native Alaskan women. 6 Smoking in pregnancy increases the risk for low birth weight and pre-term birth and is associated with other negative outcomes for the infant.…”

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confidence: 99%

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Fetal Exposure to Carcinogens With Tobacco Use in Pregnancy: Phase 1 MAW Study Findings

Flanagan

Koller

Wolfe

et al. 2016

NICTOB

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Introduction: The high prevalence of smoking and smokeless tobacco (ST) use during pregnancy in Alaska Native (AN) women is concerning due to the detrimental effects of these products to the mother and the developing fetus. We sought to correlate maternal cotinine levels with fetal exposure to a tobacco-specific carcinogen to incorporate in a biomarker feedback intervention to motivate tobacco cessation during pregnancy. Methods: Demographic and tobacco use data were collected from a convenience sample of pregnant AN smokers, ST users, and non-users. Maternal and neonatal urine were collected at delivery. Maternal urine cotinine and neonatal urine total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL, a tobacco-specific carcinogen) levels in smokers and ST users were analyzed and their correlations determined by Spearman correlation coefficients. Results: During 2012-2014, we enrolled 64 non-users, 54 smokers, and 30 ST (20 homemade iqmik; 10 commercial ST) users (n = 148). Analyses of paired maternal-infant urine samples obtained for 36 smokers demonstrated a moderate to strong correlation (r = 0.73, P < .001) between maternal cotinine and infant NNAL levels. The correlation was not significant for 25 iqmik users (r = 0.36, P = .17) or 9 commercial ST users (r = 0.60, P = .09). No analysis was conducted for 55 non-users with cotinine and NNAL levels < limits of quantification. Conclusions: There is a moderate to strong correlation between maternal smoking and fetal exposure to the tobacco-specific carcinogen NNAL. Implications: The correlation between maternal smoking and fetal carcinogen exposure may provide an education tool to help motivate smoking cessation among pregnant AN women. Further investigation is warranted to determine correlations between maternal commercial ST and iqmik use and neonatal NNAL.

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Iqmik: A Form of Smokeless Tobacco Used Among Alaska Natives

Cited by 39 publications

References 12 publications

Focus Groups of Alaska Native Adolescent Tobacco Users: Preferences for Tobacco Cessation Interventions and Barriers to Participation

Focus Groups of Alaska Native Adolescent Tobacco Users: Preferences for Tobacco Cessation Interventions and Barriers to Participation

Tobacco use among Alaska Native people in the EARTH study

Fetal Exposure to Carcinogens With Tobacco Use in Pregnancy: Phase 1 MAW Study Findings

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