Quitting Tobacco For Good Health, Cleaner Communities

Maniilaq Health Center in Kotzebue, Alaska

Statewide, Alaska’s tobacco use rate hovers around 20%; it’s gone down significantly over the last decade or so, and is only slightly above the national average. But among Alaska Natives the rate is much higher – in some places, more than double – and often kids begin using tobacco at young ages. Jessica Cochran has more, in the next installment of our series “Being Young in Rural Alaska” from the producers of Kids These Days.

JESSICA COCHRAN: Samantha Lindeman began smoking when she was seven; she grew up in Quinhagak in Southwest Alaska.

[Samantha Lindeman] “My mom kind of smoked, she’d go on and off, but everyone else around me in town smoked. And it was a small town, thirty people.”

JC: Not that the adults condoned the kids using tobacco.

[Lindeman] “We’d go to the store and get candy and have someone else get us cigarettes, and then we’d have to wait hours before we could go home. So that was never fun having to wait, especially in the rain.”

JC: They’d wait until they no longer smelled like smoke. At some points, Lindeman craved cigarettes so much, it was all-consuming.

[Lindeman] “It’s just like taking care of an infant to me; that’s how it feels.”

JC: Bethel Alternative Boarding School helped Lindeman quit; they require students to stop smoking and keep pretty close tabs on them. Having a son clinched the deal: diapers and formula are expensive in Bethel. People around Lindeman still smoke, and the temptation is always there, but she’s determined not to start again.

• LEARN MORE! State of Alaska Tobacco use statistics

Much of the tobacco use in rural Alaska isn’t smoking: it’s chewing tobacco, snuff, or an extra-potent homemade blend of tobacco and punk ash fungus called iqmik, or blackbull. It’s a little easier to hide chewing than smoking– except at your dental check-up. In Saint Mary’s, dental health aide Bernadette Charles has seen signs of kids as young as 8-years old chewing tobacco products.

[Bernadette Charles] “Most times they say no, no they don’t, but you can notice how that tobacco pouch is in the mouth, it’s been there for quite some time. It’ll have some sloughed up tissue or be red and wrinkly.”

JC: Charles says patients argue that they have relatives who have used it for years, with no problems; but she tries to remind them tobacco use is linked to many forms of cancer – and cancer is the leading cause of death for Alaska Natives in the region.

Laura Ellsworth is manager for the nicotine control and research program at Yukon-Kuskokwim Health Corporation. The program used to focus primarily on helping people quit, but she’s trying widen that effort to include more education and prevention efforts across the region. Tobacco use hasn’t been at the forefront of community conversations, maybe because, as Ellsworth says, it doesn’t fit with the culture to judge others, to tell them how they should live. She’s trying to break through that barrier.

[Laura Ellsworth] “I like to get local community members, people who have lived here a long time, who are Alaska Native to bring that message back to their peer group. So to say, I am Alaska Native, I value our culture very highly. Here are some things I know about tobacco, these are the reasons I don’t use it, these are the reasons I quit.”

• LEARN MORE! Laura Ellsworth’s You Tube video on why she works to reduce nicotine use.

JC: In Kotzebue, a group of teen leaders have taken on tobacco use as one of their main causes. They’ve focused on enforcing the no-smoking- or-chewing rules at school – and teaching younger kids about the health risks, and general yuckiness of tobacco use. Fourteen-year old Nyla Ivanoff:

[Nyla Ivanoff] “Like this morning, I saw somebody spit on the gym floor. And the gym floor is new. Smoking is not only bad for the air but for the communities, for the families.”

JC: Members of the group have performed plays for younger kids, trying to spread the message. Michelle Woods of Maniilaq Association says kids need to get these prevention messages at school, because they don’t always get them at home: parents didn’t grow up with anti-tobacco messages and some don’t understand the health risks to their kids.

[Michelle Woods] “We’ve had reports back that parents will use chew tobacco as a reward for good behavior; if a toddler is crying, they’ll use it and put it in their gums to calm them.”

JC: Iqmik has come to be associated with Alaska Native traditions; one study showed people who use it are more likely to participate in subsistence activities, to be actively engaged in their Alaska Native culture. But as anti-tobacco advocates see it, since tobacco was introduced to Alaska Natives by westerners, none of its forms are truly traditional. Elmer Howarth Junior is a tobacco cessation counselor for Maniilaq.

[Elmer Howarth Junior] “It isn’t in our culture but it kind of got adopted in, you know you go hunting you see your dad chew or smoke a cigarette and you start too. So we’re trying to break that tradition – that non-tradition – and restore who we are as Alaska Natives.”

• LEARN MORE! Anchorage Daily News article on Iqmik

JC: It’s a message he hopes will catch on. Two-thirds of underage users report they get their tobacco from others in the community.  So successfully reducing tobacco use isn’t just about individual habits, it’s about addressing the social norms of entire communities.

This reporting series is a production of the Content Producers Guild and is made possible through funding from the Association of Alaska School Boards’ Initiative for Community Engagement program. For more photos and information please visit KidsTheseDays.org.

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