title: Tobacco use and cessation among pregnant Alaska Natives from Western Alaska enrolled in the WIC program, 2001-2002.
abstract: OBJECTIVE
  This study examined the rate of tobacco use (cigarette smoking and smokeless tobacco [ST]) at three time points: during the 3 months before pregnancy, during pregnancy, and at 6 weeks postpartum among Alaska Native women residing in the Y-K Delta region of Western Alaska.
  
  
  METHODS
  A retrospective, non-randomized observational cohort design was utilized. The sample consisted of 832 Alaska Natives (mean maternal age = 26.2 years, average length of gestation = 3.8 months) seen at their first prenatal visit and enrolled in the women, infant, and children (WIC) program at the Yukon-Kuskokwim Delta Regional Hospital in Bethel, Alaska, during a 2-year-period (2001-2002). Tobacco use was assessed using an interview format at the first prenatal and at the 6-week postpartum visits.
  
  
  RESULTS
  The rates of any tobacco use were 48% (95% CI 45%, 52%) 3 months before pregnancy, 79% (95% CI 76%, 82%) during pregnancy, and 70% (95% CI 67%, 74%) at 6 weeks postpartum. The proportion of women using ST changed significantly (P < 0.001) over the three time points (14%, 60%, and 61%, respectively) as well as the proportion of women who smoked cigarettes (P < 0.001) (40%, 42%, and 19%, respectively).
  
  
  CONCLUSIONS
  This study documents the high rate of tobacco use, particularly ST use, during pregnancy among Alaska Native women. Development of tobacco use prevention and cessation interventions during pregnancy for Alaska Native women is warranted.
authors.affiliation: Mayo Clinic College of Medicine, Mayo Clinic Cancer Center, Charlton 6-273, 200 First Street SW, Rochester, MN 55905, USA. patten.christi@mayo.edu
authors.forename: Christi A
authors.initials: CA
authors.lastname: Patten
authors.forename: Caroline C
authors.initials: CC
authors.lastname: Renner
authors.forename: Paul A
authors.initials: PA
authors.lastname: Decker
authors.forename: Ester
authors.initials: E
authors.lastname: O'Campo
authors.forename: Karin
authors.initials: K
authors.lastname: Larsen
authors.forename: Carrie
authors.initials: C
authors.lastname: Enoch
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Offord
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hurt
authors.forename: Anne
authors.initials: A
authors.lastname: Lanier
authors.forename: Judith
authors.initials: J
authors.lastname: Kaur
mesh_terms: D000293:Adolescent; D000328:Adult; D000413:Alaska / Q000453:epidemiology; D016001:Confidence Intervals; D019992:Databases as Topic; D005260:Female; D017144:Focus Groups; D005522:Food Services; D006801:Humans; D004930:Inuit / Q000706:statistics & numerical data*; D016015:Logistic Models; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D055815:Young Adult