Epperson Anna E, Crouch Maria, Skan Jordan, Benowitz Neal L, Schnellbaecher Matthew, Prochaska Judith J
Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, United States.
Cardiology Department, Alaska Native Tribal Health Consortium, Anchorage, United States.
Tob Induc Dis. 2020 Jun 16;18:55. doi: 10.18332/tid/122902. eCollection 2020.
Approximately 9 million American adults use two or more tobacco products regularly, referred to as dual or poly tobacco users. In Alaska, where tobacco is not native, approximately 20% of the population smokes cigarettes, and among smokers, 10% use two or more tobacco products. Previous research suggests that dual tobacco product use may be especially high among Alaska Native people. The current study examined cultural and demographic characteristics associated with dual tobacco use.
Alaska Native adults reporting daily smoking and identified with high blood pressure or cholesterol were recruited in the Norton Sound region of Alaska between 2015-2019 as part of a treatment trial targeting cardiovascular disease risk factors. Participants reported their tribal group, level of identification with their Alaska Native heritage, speaking of their tribal language, basic demographic characteristics, and past 30-day use of tobacco products in addition to smoking cigarettes.
Participants (n=299) were 48.5% female and identified as Yup'ik (31.1%), Inupiat (60.5%), and other or multiple tribal group(s) (8.4%). Most participants (85.3%) strongly identified with their Alaska Native heritage. Past 30-day dual tobacco use was reported by 10.0%, specifically 9.0% chew/snuff, 1.3% e-cigarettes, and 0.7% Iq'mik. Multivariate regression models indicated that dual tobacco use was more likely among men (OR=3.35; 95% CI: 1.30-8.64), younger participants (OR range: 10.97-12.35; 95% CI: 2.33-57.86), those identifying as Yup'ik (OR=2.86; 95% CI: 1.13-7.19), and those who identified very little or not at all with their Alaska Native heritage (OR=2.98; 95% CI: 1.14-7.77).
Young men identifying as Yup'ik were more likely to use dual forms of tobacco. Stronger identification with one's Alaska Native heritage was associated with lower risk of dual tobacco use. The findings highlight cultural and demographic factors for further consideration and attention in tobacco cessation treatment interventions.
约900万美国成年人经常使用两种或更多烟草制品，即双重或多重烟草使用者。在烟草并非本土作物的阿拉斯加，约20%的人口吸烟，在吸烟者中，10%使用两种或更多烟草制品。先前的研究表明，阿拉斯加原住民中双重烟草制品的使用率可能特别高。本研究调查了与双重烟草使用相关的文化和人口特征。
2015年至2019年期间，在阿拉斯加诺顿湾地区招募了报告每日吸烟且患有高血压或高胆固醇的阿拉斯加原住民成年人，作为一项针对心血管疾病风险因素的治疗试验的一部分。参与者报告了他们的部落群体、对阿拉斯加原住民血统的认同程度、是否会说部落语言、基本人口特征，以及除吸烟外过去30天内烟草制品的使用情况。
参与者（n = 299）中48.5%为女性，分别为尤皮克人（31.1%）、因纽皮亚特人（60.5%）以及其他或多个部落群体（8.4%）。大多数参与者（85.3%）强烈认同自己的阿拉斯加原住民血统。报告过去30天内使用双重烟草制品的比例为10.0%，具体为9.0%嚼烟/鼻烟、1.3%电子烟和0.7%伊克米克烟。多变量回归模型表明，男性（OR = 3.35；95% CI：1.30 - 8.64）、年轻参与者（OR范围：10.97 - 12.35；95% CI：2.33 - 57.86）、认同自己为尤皮克人的参与者（OR = 2.86；95% CI：1.13 - 7.19）以及对阿拉斯加原住民血统认同度很低或完全不认同的参与者（OR = 2.98；95% CI：1.14 - 7.77）使用双重烟草制品的可能性更高。
认同自己为尤皮克人的年轻男性使用双重烟草制品的可能性更高。对自己阿拉斯加原住民血统的更强认同与双重烟草使用风险较低相关。这些发现突出了在戒烟治疗干预中需要进一步考虑和关注的文化和人口因素。
