title: Tobacco use during pregnancy among Alaska Natives in western Alaska.
abstract: OBJECTIVE
  To determine tobacco use rates during pregnancy among Alaska Natives residing on the Yukon-Kuskokwim (Y-K) Delta of western Alaska. Alaska Natives residing in this region use Iqmik, a unique form of smokeless tobacco (ST).
  
  
  METHODS
  Retrospective cohort study. The medical records of the most recent consecutive 100 Alaska Native women delivering within the Y-K Health Corporation system in 2001 were abstracted for information on tobacco use during this pregnancy and basic demographics.
  
  
  RESULTS
  Of the 100 women, 24 did not use tobacco, 55 used ST only, 18 smoked cigarettes only, and 3 used both ST and smoked cigarettes during this pregnancy. Of the 58 who used ST, 22 used Iqmik only, 32 used commercial ST only, and 4 used both. The frequency of ST use increased significantly with age (p=0.007; OR=1.65 per 5-year increase in age, 95% CI 1.15 to 2.36), while the frequency of cigarette smoking tended to decrease with age (p=0.254; OR=0.79 per 5-year increase in age, 95% CI 0.53 to 1.18).
  
  
  CONCLUSIONS
  A high proportion of Alaska Native women use tobacco during pregnancy. The rate of ST use (58%) among pregnant Alaska Native women is markedly higher than the prevalence of ST use (0.5%) among women in the general U.S. population.
authors.affiliation: Alaska Native Tribal Health Consortium, Office of Alaska Native Health Research, 4201 Tudor Centre Drive, Suite 105, Anchorage, AK 99508, USA. ccrenner@anmc.org
authors.forename: Caroline C
authors.initials: CC
authors.lastname: Renner
authors.forename: Christi A
authors.initials: CA
authors.lastname: Patten
authors.forename: Gretchen E
authors.initials: GE
authors.lastname: Day
authors.forename: Carrie C
authors.initials: CC
authors.lastname: Enoch
authors.forename: Darrel R
authors.initials: DR
authors.lastname: Schroeder
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Offord
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hurt
authors.forename: Ann
authors.initials: A
authors.lastname: Gasheen
authors.forename: Leigh
authors.initials: L
authors.lastname: Gill
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000413:Alaska / Q000453:epidemiology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D004930:Inuit / Q000706:statistics & numerical data*; D016015:Logistic Models; D008423:Maternal Age; D016017:Odds Ratio; D044382:Population Groups / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology* / Q000209:etiology; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012907:Smoking / Q000208:ethnology*; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000208:ethnology*