Differences in cigarette and smokeless tobacco use among American Indian and Alaska Native people living in Alaska and the Southwest United States.
BACKGROUND
This study analyzed self-reported tobacco use among American Indian and Alaska Native (AI/AN) people enrolled in the Education and Research Towards Health Study in Alaska (n = 3,821) and the Southwest United States (n = 7,505) from 2004 to 2006.


METHODS
Participants (7,060 women and 4,266 men) completed a computer-assisted self-administered questionnaire on cigarette and smokeless tobacco (ST) use.


RESULTS
Current use of cigarettes was considerably higher in Alaska than in the Southwest United States (32% vs. 8%). Current ST use was also more common in Alaska than in the Southwest United States (18% vs. 8%). Additionally, smoking was more common among men, younger age, those who were not married, and who only spoke English at home, while ST use was more common among men, those with lower educational attainment and those who spoke an AI/AN language at home (p < .01). Compared with the U.S. general population, AI/AN people living in Alaska were more likely and those living in the Southwest United States were less likely to be current smokers. Rates of ST use, including homemade ST, in both regions were much higher than the U.S. general population.


CONCLUSIONS
Tobacco use among AI/AN people in the Southwest United States, who have a tradition of ceremonial tobacco use, was far lower than among Alaska Native people, who do not have a tribal tradition. Tobacco use is a key risk factor for multiple diseases. Reduction of tobacco use is a critical prevention measure to improve the health of AI/AN people.
Redwood
Diana
D
4000 Ambassador Drive, C-DCHS, Anchorage, Alaska 99508, USA. dredwood@anthc.org
Lanier
Anne P
AP
Renner
Caroline
C
Smith
Julia
J
Tom-Orme
Lillian
L
Slattery
Martha L
ML
D000293:Adolescent; D000328:Adult; D000368:Aged; D000413:Alaska / Q000453:epidemiology; D003466:Cultural Characteristics; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012907:Smoking / Q000208:ethnology*; D015206:Southwestern United States / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014030:Tobacco, Smokeless; D055815:Young Adult