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Am J Prev Med. 2015 Nov;49(5):738-744. doi: 10.1016/j.amepre.2015.05.002. Epub 2015 Jul 7.

Disparities in Smoking-Related Mortality Among American Indians/Alaska Natives.

Author information

1
Biostatistics, Inc., Sarasota, Florida. Electronic address: pzm4@cdc.gov.
2
Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia.
3
Office on Smoking and Health, CDC, Atlanta, Georgia.
4
Black Hills Center for American Indian Health, Rapid City, South Dakota.

Abstract

INTRODUCTION:

Smoking-related disparities continue to be a public health problem among American Indian/Alaska Native (AI/AN) population groups and data documenting the health burden of smoking in this population are sparse. The purpose of this study was to assess mortality attributable to cigarette smoking among AI/AN adults relative to non-Hispanic white adults (whites) by calculating and comparing smoking-attributable fractions and mortality.

METHODS:

Smoking-attributable fractions and mortality among AI/ANs (n=1.63 million AI/ANs) and whites were calculated for people living in 637 Indian Health Service Contract Health Service Delivery Area counties in the U.S., from mortality data collected during 2001-2009. Differences in smoking-attributable mortality between AI/ANs and whites for five major causes of smoking-related deaths were examined. All data analyses were carried out in 2013-2014.

RESULTS:

Overall, from 2001 to 2009, age-adjusted death rates, smoking-attributable fractions, and smoking-attributable mortality for all-cause mortality were higher among AI/ANs than among whites for adult men and women aged ≥35 years. Smoking caused 21% of ischemic heart disease, 15% of other heart disease, and 17% of stroke deaths in AI/AN men, compared with 15%, 10%, and 9%, respectively, for white men. Among AI/AN women, smoking caused 18% of ischemic heart disease deaths, 13% of other heart diseases deaths, and 20% of stroke deaths, compared with 9%, 7%, and 10%, respectively, among white women.

CONCLUSIONS:

These findings underscore the need for comprehensive tobacco control and prevention efforts that can effectively reach and impact the AI/AN population to prevent and reduce smoking.

PMID:
26163166
DOI:
10.1016/j.amepre.2015.05.002
[Indexed for MEDLINE]

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