Tobacco Prevention and Policy in Alaska
By Angela Gonzalez, Communications Coordinator, RurAL CAP
It is no wonder that throughout Alaska and the country, health organizations and clinics are developing tobacco cessation programs in increasing numbers. Dr. Gary Ferguson, Director of Wellness and Prevention at the Alaska Native Tribal Health Consortium, shared that U.S. Surgeon General Dr. Regina M. Benjamin recently submitted the 30th Tobacco-related Surgeon General’s report in which she writes, “Although we have made great strides in tobacco control, more than 440,000 deaths each year are caused by smoking and exposure to secondhand smoke. The cost to the nation is tremendous: a staggering amount is spent on medical care and lost productivity. But most importantly there is immeasurable cost in human suffering and loss.”
Dr. Ferguson adds, “Each of us are leaders in our circles of friends and family. It’s time that we stand up with our local, state and national health leaders and decide to be tobacco-free.”
According to a 2004 report, Tobacco in the Great Land: A Portrait of Alaska’s Leading Cause of Death, tobacco use is the leading cause of preventable death in Alaska. Tobacco use was responsible for approximately one in every five deaths in Alaska in 2001. The four primary tobacco-related causes of death in Alaska are lung cancer, ischemic heart disease, stroke, and chronic obstructive pulmonary disease. The four primary causes of tobacco related death are all chronic conditions from which a person may suffer for years, undergoing repeated hospitalizations.
According to the Center for Disease Control and Prevention, smoking harms nearly every organ of the body. Smoking causes many diseases and reduces the health of smokers in general.
Compared with nonsmokers, smoking is estimated to increase the risk of:
• coronary heart disease by 2 to 4 times
• stroke by 2 to 4 times • men developing lung cancer by 23 times
• women developing lung cancer by 13 times
• dying from chronic obstructive lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times.
Smoking causes the following cancers:
• Acute myeloid leukemia
• Bladder cancer
• Cancer of the cervix
• Cancer of the esophagus
• Kidney cancer
• Cancer of the larynx (voice box)
• Lung cancer
• Cancer of the oral cavity (mouth)
• Cancer of the pharynx (throat)
• Stomach cancer
• Cancer of the uterus
Tobacco use for adults and youth in Alaska is higher than the rest of the nation. In 2008, 43% of Alaska Natives used tobacco compared to 19% of non-Native people. Many health organizations and clinics have developed tobacco cessation programs throughout Alaska to help people quit tobacco use. The Alaska Tobacco Control Alliance (ATCA) works to create conditions in Alaska that are tobacco-free. ATCA was formed in 1992 to create a statewide network of health advocates to develop, support and sustain comprehensive tobacco control programs. One of the many resources available to Alaskans who want to stop tobacco use is Alaska’s Tobacco Quit Line. See detail in box and the other resources included throughout this article.
An increasing number of organizations are beginning to include tobacco-free initiatives in their comprehensive wellness programs. Dana Diehl, the Disparities Program Coordinator with the State of Alaska, Tobacco Prevention and Control Program, says tobacco control initiatives like smokefree workplace policies and increases in tobacco taxes work to protect people from exposure to secondhand smoke and help people to quit using tobacco. Diehl says, “Smokefree and tobacco-free workplace policies are important because they ensure that all Alaskans are protected from the harmful effects of secondhand smoke and they encourage people to quit.” She goes on to say, “All Alaskans are vulnerable to the effects of secondhand smoke but Elders, pregnant women, and children are particularly susceptible.”
The LEAD (Leadership for Eliminating Alaskan Disparities) workgroup developed the Alaska Strategic Plan for Eliminating Tobacco-Related Disparities in 2007 as an initial step in addressing tobacco-related disparities in Alaska, and to provide a framework for future work in this area. In 2010, the Alaska Tobacco Prevention and Control (TPC) Program reconvened a LEAD strategic planning team to build on the original plan and to focus on the development of detailed strategies and action steps to facilitate implementation. Download the Alaska Strategic Plan for Eliminating Tobacco-Related Disparities 2011 Update here.
LEAD’s mission is to use and institutionalize the Alaska TPC strategic plan as a framework to identify actions that will positively impact disparate groups. According to the National Institute of Health, health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.
LEAD recently held the first in a quarterly webinar series and discussed the topic of Tribal Tobacco Policy. Hospitals and clinics across the state are adopting comprehensive smoke free workplace policies. The LEAD workgroup is providing tools for tribes to adopt resolutions to make their facilities smoke free. Andrea Thomas, a LEAD work group member and the Tobacco Program Manager for the Southeast Alaska Regional Health Consortium (SEARHC), has led the smoke fee efforts in Southeast Alaska.
SEARHC’s initiatives acted upon in the Southeast communities include creating smoke free policies for tribal facilities, Alaska Native Brotherhood, Alaska Native Sisterhood, workplaces in Sitka, Klawock, Haines and Skagway; and creating tobacco taxes in Sitka and Klawock. In addition, Craig, Kake, and Wrangell businesses have volunteered to become smoke free. SEARHC has been successful in creating and promoting smoke free policies in Southeast communities, and they want to share their sample resolutions with the rest of the state. They have created a Smoke free Resolutions Fact Sheet and a draft tribal resolution, which can be downloaded at http://www.alaskatca.org/workgroups/antag. Thomas says, “One of the things we have to do is start building tribal leadership and understanding about how smoke free policies really promote health among Alaska Native people, because we have such a high rate of tobacco use.” Tribes can modify and amend the draft resolution.
Thomas says the Organized Village of Kasaan and the Native Village of Kobuk have recently passed smoke free resolutions. The Nome City Council voted earlier this year to ban smoking in public areas, such as stores, offices, bars, schools and restaurants.
Thomas says, “Smoke free campuses are very effective in reducing tobacco use.”
Cheri Hample is the Director of Chugachmiut Health Services and serves on the Alaska Native Health Board. Hample says it takes time to create and pass resolutions on smoke free policies. When community members and organizations are working with tribes to create tobacco free policies and resolutions, Hample says, “Do things in stages. Attend Tribal meetings. Build relationships with tribes. Don’t just attend one meeting.”
Alaska’s Tobacco Quit Line
Alaska’s Tobacco Quit Line is available for Alaskans who need support and assistance. The free service can be accessed 24-hours a day, 7-days a week. The Quit Line provides free, confidential telephone coaching and medication to help Alaska residents quit tobacco. Smokers and chewers can call 1-800-QUIT-NOW (1-800-784-8669) to speak with a Quit Coach and create an individualized, effective plan to guide them through the quitting process. Eight weeks of free nicotine replacement product is available to all eligible callers. Ongoing efforts tailor cessation services — for all forms of tobacco — to specific populations around the state, including Alaska Natives, pregnant women, and rural populations
Tobacco Prevention and Cessation Resources:
Alaska Native Tribal Health Consortium (ANTHC) Technical Assistance for Tobacco Treatment Programs: www.anthc.org/chs/wp/tobacco/cessation.cfm
Alaska Native Tribal Health Consortium (ANTHC) Tobacco Policy Information: www.anthc.org/chs/wp/tobacco/policy.cfm
Alaska Tobacco Prevention and Control Program: www.hss.state.ak.us/dph/chronic/tobacco/
Americans for Nonsmokers’ Rights: www.no-smoke.org/goingsmokefree.php?id=124
Break Free Alliance: http://healthedcouncil.org/breakfreealliance/index.html
Center for Disease Control: www.cdc.gov
National Native Commercial Tobacco Abuse Prevention Network (also known as Keep it Sacred): www.keepitsacred.org/toolkit
SEARHC Tobacco Prevention & Cessation: www.searhc.org/programs/tobacco_education.php
Statewide Tobacco Free Coalition
RurAL CAP is recruiting motivated teens to shape tobacco-free policy and activities for schools for a Statewide Tobacco Free Youth Coalition. Contact Amy Gorn for more information at (907) 623-0769 or firstname.lastname@example.org.
Source: Alaska Behavioral Risk Factor Surveillance System (AK BRFSS) Information courtesy of the Leadership for Eliminating Alaskan Disparities (LEAD) workgroup.
About RurAL CAP
RurAL CAP, a statewide, 501(c)(3) non-profit corporation, has been working to improve the quality of life for low-income Alaskans since 1965. RurAL CAP employed 1,048 Alaskans in 2010 with expenditures of more than $32 million. It provides resources and services to enhance child and family development, improve housing, reduce energy costs, develop leadership, protect traditional uses of fish and game, improve solid waste management, support health and wellness, develop community plans, and foster independent living.