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.