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Henderson P.N.,Black Hills Center for American Indian Health
Nicotine and Tobacco Research

Introduction: Little is known about the scope of the tribally manufactured cigarette market. This study illuminates the topic by examining the Master Settlement Agreement Compliance Tobacco Directories, regularly updated documents that list the cigarette manufacturers and brand families that can be legally sold within participating states. Methods: In July 2014, the latest Tobacco Directories were identified for 43 states and the District of Columbia. Colorado archival tobacco directories were extracted, by month since 2003. Tribal manufacturers and brands were identified in the directories and mapped by state. Results: A total of 11 tribal manufacturers and 39 tribal cigarette brand families were identified in publicly available tobacco directories. Total unique brands were tallied by state, ranging from 1 to 24 unique brands. Historical data from Colorado showed that tribal manufacturers, as a percentage of all manufacturers, increased from 3.2% in 2003 to 20.6% by mid-2014. Discussion: Analysis of Tobacco Directories offers an innovative approach to better understand the tribally manufactured cigarette market. More research is needed to understand reporting and compliance to the Tobacco Directories by manufacturers and retailers, and their usefulness as a research tool to the tobacco control community. Implications: This study aims to make three contributions to the literature: (1) identify tribal tobacco manufacturers and brands in the Master Settlement Agreement Compliance documents; (2) highlight the presence and scope of the tribally manufactured cigarette brands across the United States; and (3) observe any upward or downward trends in tobacco brands and manufacturers since the directories' implementation. Source

Kunitz S.J.,University of Rochester | Veazie M.,Health-U | Henderson J.A.,Black Hills Center for American Indian Health
American Journal of Public Health

American Indian and Alaska Native (AI/AN) death rates declined over most of the 20th century, even before the Public Health Service became responsible for health care in 1956. Since then, rates have declined further, although they have stagnated since the 1980s. These overall patterns obscure substantial regional differences. Most significant, rates in the Northern and Southern Plains have declined far less since 1949 to 1953 than those in the East, Southwest, or Pacific Coast. Data for Alaska are not available for the earlier period, so its trajectory of mortality cannot be ascertained. Socioeconomic measures do not adequately explain the differences and rates of change, but migration, changes in selfidentification as an AI/AN person, interracial marriage, and variations in health care effectiveness all appear to be implicated. Source

Bowen D.J.,Boston University | Henderson P.N.,Black Hills Center for American Indian Health | Harvill J.,Section of Chronic Disease | Buchwald D.,University of Washington
Journal of Medical Internet Research

Background: The rate of smoking commercial tobacco products among American Indian youth is double the rate for white youth. Interventions are needed to reduce this disparity. Objective: To test the feasibility of a Web-based intervention to influence attitudes toward and intentions about smoking cigarettes among American Indian youth who attended a Native summer camp in the Northern Plains. Methods: The study website, the SmokingZine, was originally developed and tested in Canadian youth, then adapted to be appropriate for American Indian youth. We conducted a randomized controlled trial to test the influence of exposure to the adapted SmokingZine website on smoking attitudes and behaviors among American Indian youth 12-18 years of age. Participants assigned to the intervention group were given access to the website for 1 hour per day during their camp experience and asked to sign in to the site and use it. Control group participants were not given access to the site. Results: A total of 52% of intervention youth signed in to the website at least once. Among nonsmokers, intentions to try a cigarette in the intervention group declined from 16% to 0%, and increased from 8% to 25% in the control group (P <.05). Compared with the control group, youth in the intervention group were more likely to help others quit (21 percentage point change in intervention versus no change in control; P <.05) and had less positive attitudes about the drug effects of smoking (-0.19 change in intervention versus 0.67 in control; P <.05). Conclusion: These data indicate that SmokingZine needs more long-term, rigorous investigation as a way to keep American Indian youth from becoming regular smokers. Because the intervention group could use computers only 1 hour per day, increasing access might result in more visits and a greater effect of the website on smoking behaviors. © Deborah J. Bowen, Patricia Nez Henderson, Jessica Harvill, Dedra Buchwald. Source

Veazie M.,Phoenix Area Indian Health Service | Ayala C.,Centers for Disease Control and Prevention | Schieb L.,Centers for Disease Control and Prevention | Dai S.,Centers for Disease Control and Prevention | And 2 more authors.
American Journal of Public Health

Objectives. We evaluated heart disease death rates among American Indians and Alaska Natives (AI/ANs) and Whites after improving identification of AI/AN populations. Methods. Indian Health Service (IHS) registration data were linked to the National Death Index for 1990 to 2009 to identify deaths among AI/AN persons aged 35 years and older with heart disease listed as the underlying cause of death (UCOD) or 1 of multiple causes of death (MCOD). We restricted analyses to IHS Contract Health Service Delivery Areas and to non-Hispanic populations. Results. Heart disease death rates were higher among AI/AN persons than Whites from 1999 to 2009 (1.21 times for UCOD, 1.30 times for MCOD). Disparities were highest in younger age groups and in the Northern Plains, but lowest in the East and Southwest. In AI/AN persons, MCOD rates were 84% higher than UCOD rates. From 1990 to 2009, UCOD rates declined among Whites, but only declined significantly among AI/AN persons after 2003. Conclusions. Analysis with improved race identification indicated that AI/AN populations experienced higher heart disease death rates than Whites. Better prevention and more effective care of heart disease is needed for AI/AN populations. Source

Hoffman R.M.,University of New Mexico | Li J.,New Mexico VA Health Care System | Henderson J.A.,Black Hills Center for American Indian Health | Ajani U.A.,New Mexico VA Health Care System | And 2 more authors.
American Journal of Public Health

Objectives. We linked databases to improve identification of American Indians/ Alaska Natives (AI/ANs) in determining prostate cancer death and incidence rates. Methods. We linked prostate cancer mortality and incidence data with Indian Health Service (IHS) patient records; analyses focused on residents of HIS Contract Health Service Delivery Area (CHSDA) counties. We calculated age-adjusted incidence and death rates for AI/AN and White men for 1999 to 2009; men of Hispanic origin were excluded. Results. Prostate cancer death rates were higher for AI/AN men than for White men. Death rates declined for White men (û3.0% per year) but not for AI/AN men. AI/AN men had lower prostate cancer incidence rates than White men. Incidence rates declined among Whites (û2.2% per year) and AI/ANs (û1.9% per year). Conclusions. AI/AN men had higher prostate cancer death rates and lower prostate cancer incidence rates than White men. Disparities in accessing health care could contribute to mortality differences, and incidence differences could be related to lower prostate-specific antigen testing rates among AI/AN men. Source

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