Abstract
ABSTRACTTobacco 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.
Highlights
Since 1991, data collected by the Alaska Behavioural Risk Factor Surveillance System (ABRFSS) [1] have consistently shown greater prevalence of tobacco use among Alaska Native (AN) people over the general Alaska population [2]
Surveillance reports indicate prevalence of multiple tobacco product use is on the rise, especially among young adults [17], while tobacco users who use more than one product report lower tobacco cessation rates [17,18]
During 2000–2004, three population-based cohort studies were conducted in two adjacent western Alaska regions: the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study [30], based in the Norton Sound region, and the Centers for Alaska Native Health Research (CANHR) [31] and Education and Research Towards Health (EARTH) [32] studies, based in the Y-K Delta region
Summary
Since 1991, data collected by the Alaska Behavioural Risk Factor Surveillance System (ABRFSS) [1] have consistently shown greater prevalence of tobacco use among Alaska Native (AN) people over the general Alaska population [2]. These data [3,4,5,6] show greater use of smokeless tobacco (ST) among AN people. Studies with other cohorts, such as adolescents, in which multiple forms of tobacco use are reported, indicate that tobacco cessation interventions and tobacco control policies must address dual and multiple tobacco product use in order to impact tobacco use on a population level [18,19,20]. Epidemiological studies of tobacco initiation in the US have typically reported product use initiation separately
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