title: Tobacco use among Alaska Native people in the EARTH study.
abstract: BACKGROUND
  While aggregate rates of tobacco use for Alaska Native (AN) and American Indian people are high, use rates vary among populations and factors associated with use are not fully understood. For AN people living in three regions of Alaska, we present prevalence of tobacco use as well as factors associated with use.
  
  
  METHODS
  Using data from 3,828 participant questionnaires, associations with tobacco use are examined with chi-square tests and multivariate logistic regression. Covariates investigated include demographic factors, identification with tribal tradition, language spoken in the home, binge drinking, and depression screening results.
  
  
  RESULTS
  Current smoking was more prevalent among men. In multivariate analysis, higher likelihood of current smoking was found for participants with these characteristics: younger, unmarried, low income, and increased frequency of binge drinking. For women, additional characteristics included no high school diploma and positive depression screening. Participants from southeastern Alaska were less likely to be current smokers. Current smokeless tobacco use rates were similar across gender. Higher likelihood of current smokeless use was found in southwestern Alaska and among those with positive depression screening. Women with low income and who reported at least some identification with tribal tradition had increased odds of current smokeless use. More than 20% of smokeless tobacco users reported initiating by age 10.
  
  
  CONCLUSIONS
  Rates of tobacco use by AN people continue to be higher than other U.S. populations. Tobacco initiation prevention efforts targeting AN youth at an early age are recommended, given the early age of initiation demonstrated in this study.
authors.affiliation: Research Department, Southcentral Foundation, Anchorage, Alaska 99508, USA. jsmith@southcentralfoundation.com
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Smith
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Ferucci
authors.forename: Denise A
authors.initials: DA
authors.lastname: Dillard
authors.forename: Anne P
authors.initials: AP
authors.lastname: Lanier
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000413:Alaska / Q000453:epidemiology; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology*; D000074606:Smoking Prevention; D055815:Young Adult