Smoking rates continue to decline in Alaska, according to the Alaska Department of Health and Social Services.
Between 1996 and 2013, the number of adult smokers in the state decreased by about 2.1 percent, according to the department’s 2015 Alaska Tobacco Facts update. The decrease is much more marked among the young — 11 percent of high school students smoked in 2013 compared to 37 percent in 1996.
However, rates remain disparately high among Alaska Natives versus non-Natives. Approximately 42 percent of Alaska Natives smoke, while 19 percent of non-Native adults smoke, according to the report. The rates are also higher among those of lower socioeconomic status: among non-Native adults between 25 and 64 years old, about 38 percent of people who fall into a low socioeconomic status smoke, while 14 percent of those of higher socioeconomic status do not.
This trend holds true across the country. Low-income cigarette smokers also experience more tobacco-related diseases than those with higher incomes, according to the Centers for Disease Control and Prevention. They also tend to smoke for more years as those with higher incomes, according to a 2009 study published in the Journal of Public Health.
Those disparities were identified in the last Alaska Strategic Plan for Eliminating Tobacco Related Disparities, which was published in 2011. The reason for the disparity between Alaska Natives and non-Natives is not entirely clear, as there are many factors, but the state has worked to try to close that gap, said Tari O’Connor, the section chief for Chronic Disease and Health Promotion under DHSS.
“If you focus on everything, you focus on nothing,” O’Connor said. “The first step is to look at the data and then decide to target (the high-disparity) groups.”
Pacific Islanders and Hispanic individuals also had higher rates of smoking and fewer doctor visits, according to the 2011 report. However, Alaska Natives led by a wide margin in smoking and the second lowest number of doctor visits.
The survey also showed an uptick in e-cigarette use among both high school students and adults. This year was the first year the survey asked about e-cigarettes for youth — approximately 17.7 percent of minors reported currently using e-cigarettes. Approximately 3.7 percent of adults reported using e-cigarettes in 2013, more than triple what they reported in 2010.
The state has partnered with the Indian Health Services providers and Native health corporations to try to target messages to some of the groups most disproportionately affected by smoking. Program efforts are ongoing by 25 local and regional grantees in about 200 communities statewide, according to the Tobacco Prevention and Control Program’s annual report issued in April 2016.
Of the state’s 229 federally recognized tribes, 120 of them have adopted smoke-free and tobacco-free resolutions, many of which were driven by concern about secondhand smoke, according to the annual report.
Alaska is not a smoke-free state for workplaces, restaurants or bars. A bill debated this Legislative session, sponsored by Sen. Peter Micciche, would have made it illegal to smoke in any workplace, but the bill died after the chair of the House Judiciary Committee refused to schedule the House and Senate versions for a hearing.
More homes in Alaska do not allow smoking. Approximately 87.1 percent of Alaska Natives reported that smoking was not allowed anywhere inside their homes in 2013; among non-Natives, it was 89 percent. The Tobacco Prevention and Control Program has been working with housing authorities since 2007 to implement smoke-free properties, reaching 143 properties in 2015, according to the state’s annual report. There is still a disparity between socioeconomic classes, though — among non-Natives, more of those of higher socioeconomic status reported that their homes do not allow smoking anywhere inside.
Still, the study showed many people in the state are actively trying to quit smoking. Two-thirds of Alaskans who smoke reported wanting to quit in 2013, and approximately a third said they planned to quit within the next month. More than half had attempted to quit within the last year. The state funds a free tobacco cessation service that is available to anyone who wants to quit. O’Connor said the state also works with health providers to refer current smokers to cessation services if they say they want to quit. Education is also a primary goal of the programs, she said.
“Our state program is focused not just on cessation … but we also have community programs to work on not just cessation but preventing use,” O’Connor said.
The Tobacco Prevention and Control Program’s strategic plan times out this year though, and the department will begin to look at its goals and what strategies to use to reduce use in the future, O’Connor said.
Reach Elizabeth Earl at firstname.lastname@example.org.