Tobacco Use and Cessation Among Pregnant Alaska Natives from Western Alaska Enrolled in the WIC Program, 2001–2002
First Online: 14 March 2008 Received: 17 May 2006 Accepted: 19 February 2008 DOI:
Cite this article as: Patten, C.A., Renner, C.C., Decker, P.A. et al. Matern Child Health J (2008) 12: 30. doi:10.1007/s10995-008-0331-7 Abstract Objectives This study examined the rate of tobacco use (cigarette smoking and smokeless tobacco [ST]) at three time points: during the 3 months before pregnancy, during pregnancy, and at 6 weeks postpartum among Alaska Native women residing in the Y-K Delta region of Western Alaska. Methods A retrospective, non-randomized observational cohort design was utilized. The sample consisted of 832 Alaska Natives (mean maternal age = 26.2 years, average length of gestation = 3.8 months) seen at their first prenatal visit and enrolled in the women, infant, and children (WIC) program at the Yukon-Kuskokwim Delta Regional Hospital in Bethel, Alaska, during a 2-year-period (2001–2002). Tobacco use was assessed using an interview format at the first prenatal and at the 6-week postpartum visits. Results The rates of any tobacco use were 48% (95% CI 45%, 52%) 3 months before pregnancy, 79% (95% CI 76%, 82%) during pregnancy, and 70% (95% CI 67%, 74%) at 6 weeks postpartum. The proportion of women using ST changed significantly ( P < 0.001) over the three time points (14%, 60%, and 61%, respectively) as well as the proportion of women who smoked cigarettes ( P < 0.001) (40%, 42%, and 19%, respectively). Conclusions This study documents the high rate of tobacco use, particularly ST use, during pregnancy among Alaska Native women. Development of tobacco use prevention and cessation interventions during pregnancy for Alaska Native women is warranted. Keywords Tobacco Cessation Pregnancy Alaska Native WIC References
Martin, J. A., Hamilton, B. E., Ventura, S. J., Menacker, F., & Park, M. M. (2002). Births: final data for 2000.
National Vital Statistics, 50(5), 1–104.
Gupta, P. C., & Sreevidya, S. (2004). Smokeless tobacco use, birth weight, and gestational age: population based, prospective cohort study of 1,217 women in Mumbai, India.
Krishna, K. (1978). Tobacco chewing in pregnancy.
British Journal of Obstetrics and Gynaecology, 85
Krishnamurthy, S., & Joshi, S. (1993). Gender differences and low birth weight with maternal smokeless tobacco use in pregnancy.
Journal of Tropical Pediatrics, 39
Substance Abuse and Mental Health Services Administration (2006).
Results from the 2005 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06–4194). Rockville, MD.
Centers for Disease Control and Prevention. Pregnancy Risk Assessment Monitoring System.
. Accessed 7 Dec 2007.
Hurt, R. D., Renner, C. C., Patten, C. A., et al. (2005). Iqmik—a form of smokeless tobacco used by pregnant Alaska Natives: Nicotine exposure in their neonates.
Journal of Maternal Fetal Neonatal Medicine, 17
Renner, C. C., Patten, C. A., Day, G., Hurt, R. D., & Lanier, A. P. (2005). Tobacco use during pregnancy among Alaska Natives.
Alaska Medicine, 47
Oswalt, W. (1990).
Bashful no longer: An Alaskan Eskimo ethnohistory, 1778–1988. OK: University of Oklahoma Press.
Winter, J. C. (2001).
Tobacco use by Native North Americans: Sacred smoke and silent killer. OK: Oklahoma Press.
Blanchette, R. A., Renner, C. C., Held, B., Enoch, C., & Angstman, S. (2002). The current use of
by the Eskimos of Western Alaska.
Renner, C. C., Enoch, C., Patten, C. A., et al. (2005). Iqmik: A form of smokeless tobacco used among Alaska natives.
American Journal of Health Behavior, 29
Renner, C. C., Patten, C. A., Enoch, C., et al. (2004). Focus groups of Y-K Delta Alaska Natives: Attitudes toward tobacco use and tobacco dependence interventions.
Preventive Medicine, 38
Law, K. L., Stroud, L. R., LaGasse, L. L., Niaura, R., & Lester, B. M. (2003). Smoking during pregnancy and newborn neurobehavior.
(6 Pt 1), 1318–1323.
Zeger, S. L., Liang, K. Y., & Albert, P. S. (1988). Models for longitudinal data: A generalized estimating equation approach.
Perham-Hester, K. A. (2001).
Prenatal smokeless tobacco use in Alaska, 1996–1999 Seventh Annual Maternal Child Health Epidemiology Conference. Clearwater Beach, FL.
US Department of Health and Human Services. (2001).
Women and smoking: Report of the Surgeon General. Washington, DC.
Ventura, S. J., Hamilton, B. E., Mathews, T. J., & Chandra, A. (2003). Trends and variations in smoking during pregnancy and low birth weight: Evidence from the birth certificate, 1990–2000.
Agni, M., Asma, S., Yeong, C., & Vaithinathan, R. (2001). Initiation and maintenance of tobacco use. In J. Sarnet, & S. Yoon (Eds.),
Women and the tobacco epidemic: Challenges for 21st century. Canada: World Health Organization.
England, L. J., Levine, R. J., Mills, J. L., et al. (2003). Adverse pregnancy outcomes in snuff users.
American Journal of Obstetrics Gynaecology, 189
Pelusi, J., & Krebs, L. U. (2005). Understanding cancer—Understanding the stories of life and living.
Journal of Cancer Education, 20
Stillwater, B., Echavarria, V. A., & Lanier, A. P. (1995). Pilot test of a cervical cancer prevention video developed for Alaska Native women.
Public Health Reports, 110
Tom-Orme, L. (2000). Native Americans explaining illness: Storytelling as illness experience. In B. B. Whaley (Ed.),
Explaining illness: Research, theory, and strategies (pp. 237–257). New Jersey: Mahwah. Copyright information
© Springer Science+Business Media, LLC 2008