Lewis Charley S, Nazir Niaman, Daley Sean M, Pacheco Joseph, Goeckner Ryan T, Hale Jason W, Gunville Jordyn A, Rahman Fatima, Choi Won S, Daley Christine Makosky
American Indian Health Research & Education Alliance, Inc, Kansas City, KS, USA.
Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA.
J Community Health. 2020 Aug;45(4):812-819. doi: 10.1007/s10900-020-00797-w.
American Indians have higher rates of smokeless tobacco (SLT) use than other racial/ethnic groups in the US, yet no efficacious cessation program exists for them. Because tobacco is a sacred plant to many American Indians, it is imperative that a program respect the scared nature of tobacco while encouraging quitting recreational use. All Nations Snuff Out Smokeless (ANSOS) was designed to help American Indian SLT users quit recreational tobacco use while still using it for traditional purposes. We pilot tested the ANSOS 6-month group-based counseling program (N = 48) and a shortened version consisting of a one-time education session (N = 80). Here, we discuss the tobacco characteristics of participants at baseline in both studies. Participants across studies were more likely to be male (74.2%) and have at least a college education (65%). Participants in the one-time education sessions were younger (age 35 vs age 39) and used SLT fewer days per week (4.9 vs 5.7). Two-thirds of those in the full program reported that they often substitute SLT in locations where smoking is not allowed compared to 26%. Participants in the education sessions were more likely to report daily use of traditional tobacco (20% versus 0%). Results suggest that dual use of SLT and cigarettes needs to be addressed, as does the use of SLT to circumvent public smoking rules. The role of traditional tobacco and its relationship to lower SLT use also warrants further investigation.
美国印第安人无烟烟草（SLT）的使用率高于美国其他种族/族裔群体，但针对他们却没有有效的戒烟项目。由于烟草对许多美国印第安人来说是一种神圣的植物，因此在鼓励戒掉娱乐性使用烟草的同时，项目必须尊重烟草的神圣性质。“所有民族戒掉无烟烟草”（ANSOS）项目旨在帮助美国印第安人SLT使用者戒掉娱乐性烟草使用，同时仍将其用于传统目的。我们对ANSOS为期6个月的基于小组的咨询项目（N = 48）和由一次性教育课程组成的缩短版项目（N = 80）进行了试点测试。在此，我们讨论两项研究中基线时参与者的烟草特征。两项研究中的参与者更有可能为男性（74.2%）且至少拥有大学学历（65%）。参加一次性教育课程的参与者更年轻（35岁对39岁），每周使用SLT的天数更少（4.9天对5.7天）。完整项目中有三分之二的人报告称，他们经常在禁止吸烟的场所改用SLT，而在参加教育课程的人中这一比例为26%。参加教育课程的参与者更有可能报告每天使用传统烟草（20%对0%）。结果表明，需要解决SLT和香烟的双重使用问题，以及利用SLT规避公共吸烟规定的问题。传统烟草的作用及其与较低SLT使用率的关系也值得进一步研究。
