Smoking, chewing, and cultural identity: prevalence and correlates of tobacco use among the Yup'ik-The Center for Alaska Native Health Research (CANHR) study.

Survey data were obtained from a large sample of Yup'ik participants residing in the Yukon-Kuskokwim Delta region of Alaska. Tobacco use, age, sex, and a variety of psychosocial variables were assessed. Over 75% of participants use tobacco; one half (57.4%) reported using smokeless tobacco (SLT) regularly; 28.2% reported smoking cigarettes regularly. Relative to women, men reported using SLT less, smoking cigarettes more, and using the combination of cigarettes and SLT more. Younger participants tended to smoke cigarettes more, and to use the combination of cigarettes and SLT more. SLT users displayed significantly greater enculturation by identifying more with a Yup'ik lifestyle and less with a White lifestyle, speaking their traditional language more frequently, and consuming more traditional food and medicine. In contrast, smokers tended to display significantly greater acculturation and reported using drugs and alcohol more to cope with stress. Discussion focuses on appreciating the influence of cultural factors on health behavior and on implications for intervention.