Tobacco Use Among Southwestern Alaska Native People

Renner, Caroline C.; Lanier, Anne P.; Lindgren, Bruce R.; Jensen, Joni; Patten, Christi A.; Parascandola, Mark; Benowitz, Neal L.; Tyndale, Rachel F.; Hatsukami, Dorothy K.

doi:10.1093/ntr/nts137

Cited by 19 publications

(32 citation statements)

References 11 publications

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“…This availability may also contribute to some difference in use observed between the two regions. Patterns of ST use among AN women are unlike those reported for women nationally and our results support findings for high prevalence of iqmik use by AN women reported in other studies [38,42]. The use of ST among girls and women in other countries has emerged as an important public health concern [43,44].…”

Section: Discussionsupporting

confidence: 83%

“…Other research has found that female AN youth were more likely to use ST compared to male youth in Y-K [21]. Additionally, research conducted with AN people living in the Bristol Bay region, which borders the Y-K to the south, found women more likely to use iqmik compared to men [42]. Availability, tradition, and cultural beliefs may contribute to the differences we observed in iqmik use between regions.…”

Section: Discussionmentioning

confidence: 66%

“…Only one other study assessed dual-product use by AN people, noting that men were more likely than women to be dual users [42]. That study focused only on current tobacco users in the Bristol Bay region, and did not differentiate between commercial ST and iqmik .…”

Section: Discussionmentioning

confidence: 99%

“…Research has demonstrated that dual- and multi-product tobacco users experience lower cessation rates [17,18], possibly due to greater cotinine and dependence levels [50]. On average, AN smokers living in Bristol Bay smoke about half as many cigarettes (7.8) per day [42] as US smokers (14.2) [51], but demonstrate similar plasma cotinine levels (170 ng/mL and 200 ng/mL, respectively), suggesting altered nicotine metabolism [49,52]. These changes in nicotine pharmacokinetics imply the need for a increased dosing of nicotine replacement therapy to aid in smoking cessation, a need that may extend to other AN populations, such as those in the Y-K or Norton Sound regions.…”

Section: Discussionmentioning

confidence: 99%

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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

Koller

Flanagan

Day

et al. 2017

International Journal of Circumpolar Health

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Tobacco use prevalence among Alaska Native (AN) people living in Alaska is greater than the general population prevalence statewide and nationally. Better understanding of regional tobacco use is needed to improve cessation efforts and reduce prevalence. Using self-reported baseline data from the Western Alaska Tribal Collaborative for Health study, we describe tobacco use patterns among AN people in two western Alaska regions. Data were stratified by age group and sex. Dual- and multi-product use in the Yukon-Kuskokwim (Y-K) region was stratified by concurrent vs sequential use. Overall, 87% of the cohort reported having used tobacco. In Norton Sound, cigarette (98%) was the predominant tobacco type. In Y-K 71% smoked, 76% used smokeless tobacco (ST), with 47% reporting use of both products. ST use in Y-K consisted of commercial ST and homemade iqmik. Y-K women reported more ST product use, while men reported more cigarette use. Among dual- and multi-product users, the majority reported concurrent use, with no significant differences between men and women. Distinct regional differences include high smoking prevalence in Norton Sound and frequent use of smoking and ST products in Y-K. Findings support modification of cessation programmes to address regional variations in tobacco use patterns.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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

Koller

Flanagan

Day

et al. 2017

International Journal of Circumpolar Health

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“…Exposure to second-hand smoke was assessed using standard measures adapted in prior studies of tobacco use in AN adults (Benowitz et al, 2012, Renner et al, 2013). These items assessed how much time respondents were exposed to cigarette smoke in a usual day at home, work, or during social activities with response options: < 30 min, 30 min to < 1 h, 1–3 h, 4–7 h, or 8 or more hours; how many people who lived in their home (excluding the respondent) smoked cigarettes or chewed tobacco.…”

Section: Methodsmentioning

confidence: 99%

Tobacco use and preferences for wellness programs among health aides and other employees of an Alaska Native Health Corporation in Western Alaska

Patten¹,

Bronars²,

Scott³

et al. 2017

Preventive Medicine Reports

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This study assessed health behaviors and preferences for wellness programs among employees of a worksite serving Alaska Native-people. Village-based Community Health Aides/Practitioners (CHA/Ps) were compared with all other employees on health indicators and program preferences. Using a cross-sectional design, all 1290 employees at the Yukon Kuskokwim Health Corporation (YKHC) in Western Alaska were invited in 2015 to participate in a 30-item online survey. Items assessed health behaviors, perceived stress, resiliency, and preferences for wellness topics and program delivery formats. Respondents (n = 429) were 77% female and 57% Alaska Natives. CHA/Ps (n = 46) were more likely than all other employees (n = 383) to currently use tobacco (59% vs. 36%; p = 0.003). After adjusting for covariates, greater stress levels were associated (p = 0.013) with increased likelihood of tobacco use. Employees reported lower than recommended levels of physical activity; 74% had a Body Mass Index (BMI) indicating overweight or obese. Top preferences for wellness topics were for eating healthy (55%), physical activity (50%), weight loss (49%), reducing stress (49%), and better sleep (41%). CHA/Ps reported greater interest in tobacco cessation than did other employees (37% vs. 21%; p = 0.016). Preferred program delivery format among employees was in-person (51%). The findings are important because tailored wellness programs have not been previously evaluated among employees of worksites serving Alaska Native people. Promoting healthy lifestyles among CHAP/s and other YKHC employees could ultimately have downstream effects on the health of Alaska Native patients and communities.

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Community-Based Study Recruitment of American Indian Cigarette Smokers and Electronic Cigarette Users

et al. 2017

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Data on the effectiveness of strategies for the recruitment of American Indians (AIs) into research is needed. This study describes and compares methods for identifying and recruiting AI tobacco users into a pilot study. Community-based strategies were used to recruit smokers (n = 35), e-cigarette users (n = 28), and dual users (n = 32) of AI descent. Recruitment was considered proactive if study staff contacted the individual at a pow wow, health fair, or vape shop and participation on-site or reactive if the individual contacted the study staff and participation occurred later. Screened, eligible, participated and costs and time spent were compared with Chi square tests. To understand AI descent, the relationship between number of AI grandparents and AI blood quantum was examined. Number of participants screened via the proactive strategy was similar to the reactive strategy (n = 84 vs. n = 82; p-value = 0.8766). A significantly greater proportion of individuals screened via the proactive than the reactive strategy were eligible (77 vs. 50%; p-value = 0.0002) and participated (75 vs. 39%; p-value = < 0.0001). Per participant cost and time estimated for the proactive strategy was $89 and 87 min compared to $79 and 56 min for the reactive strategy. Proportion at least half AI blood quantum was 32, 33, and 70% among those with 2, 3, and 4 AI grandparents, respectively (p = 0.0017). Proactive strategies resulted in two-thirds of the sample, but required more resources than reactive strategies. Overall, we found both strategies were feasible and resulted in the ability to reach sample goals. Lastly, number of AI biological grandparents may be a good, non-invasive indicator of AI blood quantum.

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Tobacco Use Among Southwestern Alaska Native People

Abstract: Introduction: We examined the characteristics, attitudes, beliefs, and exposure to tobacco products in a cohort of rural dwelling Alaska Native (AN) people.

Cited by 19 publications

References 11 publications

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

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

Tobacco use and preferences for wellness programs among health aides and other employees of an Alaska Native Health Corporation in Western Alaska

Community-Based Study Recruitment of American Indian Cigarette Smokers and Electronic Cigarette Users

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