Discovering unique tobacco use patterns among Alaska Native people

BACKGROUND: Alaska Native people are disproportionately impacted by tobacco-related diseases in comparison to non-Native Alaskans. DESIGN: We used Alaska’s Behavioral Risk Factor Surveillance System (BRFSS) to describe tobacco use among more than 4,100 Alaska Native adults, stratified by geographic region and demographic groups. RESULTS: Overall tobacco use was high: approximately 2 out of every 5 Alaska Native adults reported smoking cigarettes (41.2%) and 1 in 10 reported using smokeless tobacco (SLT, 12.3%). A small percentage overall (4.8%) reported using iq’mik, an SLT variant unique to Alaska Native people. When examined by geographic region, cigarette smoking was highest in remote geographic regions; SLT use was highest in the southwest region of the state. Use of iq’mik was primarily confined to a specific area of the state; further analysis showed that 1 in 3 women currently used iq’mik in this region. CONCLUSION: Our results suggest that different types of tobacco use are epidemic among diverse Alaska Native communities. Our results also illustrate that detailed analysis within racial/ethnic groups can be useful for public health programme planning to reduce health disparities.