Tobacco use and cessation: What matters to Southeast Alaska Native young adults?

Introduction: Smoking rate disparities exist for young Alaska Native adults in Southeast Alaska (70% vs. 30% for non-Native young adults). A qualitative research study was commissioned by the tribal health authority, Southeast Alaska Regional Health Consortium, to investigate this priority population's views and attitudes towards smoking and cessation to inform development of a tailored intervention. Methods: Purposive sampling was used to recruit Alaska Native smokers (n=16) and ex-smokers (n=7), age 19-29, for five focus groups and four individual interviews in Juneau, Alaska. A single semi-structured interview guide was used to explore young adults' perceptions of the advantages and disadvantages of smoking and barriers to quitting. Verbatim transcripts were coded using the constant comparative method and member-checked by tribal co-facilitators. Results: Almost all participants indicated an interest in quitting cigarettes but expressed a preference for quitting “cold turkey” rather than relying on a quit support program. Major reasons for continuing to smoke included stress relief and social norms, especially extended family. Major reasons for wanting to quit smoking included near term health issues, social image, and impact on children in the extended family. Conclusions: Results for this group of young adults are similar to those from other studies in the sparse smoking cessation literature concerning this age group. Compared to studies conducted among different young adult populations, the financial burden of smoking was less significant and the consideration of extended family members was more significant. To attract these young adults to tribal cessation programs, counseling should be de-emphasized and individualization emphasized.