title: Prevalence and predictors of tobacco use among Lumbee Indian women in Robeson County, North Carolina.
abstract: Tobacco use among some Native American tribes is high compared to the overall US population. Little is known, however, about tobacco use among Native Americans in North Carolina, a state with strong economic ties to tobacco. To assess the epidemiology of tobacco use in this population, data from the North Carolina Native American Cervical Cancer Project was reviewed. Nine hundred eighty-two Lumbee Indian women in Robeson County provided general demographic information as well as information on cancer risk knowledge, attitudes and behaviors during the 5-year study. Women were selected from the community using a random sample of 5200 persons from the tribal roll of approximately 40,000 persons. 20.6% of women were current smokeless tobacco users, while 23.7% were current smokers. Demographic and social support predictors were unique for the different types of tobacco use. Cigarette smoking was associated with younger age, higher education, excellent or good self-reported health, having a recent physical exam, separated or divorced marital status, low church participation, and alcohol consumption. Conversely, use of smokeless tobacco was associated with older age, lower education level, fair or poor self-reported health, widowed marital status, and having a high number of friends. These data show a high prevalence of smokeless tobacco use among women in this population, and a contrast in the predictors of tobacco use by source. Intervention programs for tobacco use cessation should be sensitive to these differences.
authors.affiliation: Department of Family and Community Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Spangler
authors.forename: R A
authors.initials: RA
authors.lastname: Bell
authors.forename: M B
authors.initials: MB
authors.lastname: Dignan
authors.forename: R
authors.initials: R
authors.lastname: Michielutte
mesh_terms: D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004493:Education; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D010947:Plants, Toxic; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation; D012944:Social Support; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014030:Tobacco, Smokeless