Bay Mills Indian Community Adult Tobacco Survey Findings

Submitted by: Janis Weber, Ph.D. JCW Research & Evaluation Group, Inc. 1291 US Hwy 1 N, Ste 7 Ormond Beach, FL 32174 (386) 441-4592 janis@jcwevaluation.com September 14, 2012

Introduction

The Bay Mills Indian Community Nation Adult Tobacco Survey (BMIC ATS) was implemented July, 2011 through February, 2012. The purpose of the BMIC ATS was to determine commercial tobacco knowledge, attitudes and behaviors of the Bay Mills Indian Community (BMIC). Data collected will establish a baseline against which future progress by commercial tobacco control and prevention interventions can be measured. A total of 70 surveys were completed. This report provides the highlights of findings and provides key univariate and bivariate analyses.

Methodology The total of adult members of Bay Mills Indian Community is 1306. Resulting from input from their stakeholder Bay Mills Medical Center, Bay Mills Community College chose a random sample from only those BMIC adult members who reside in Chippewa County. The number of BMIC adult members residing in Chippewa County is 813. The study has a Confidence Level of 95 and a Confidence Interval of 11. Bay Mills Community College students were recruited to serve as face-to-face interviewers as the protocols of the American Indian Adult Tobacco Survey mandate face-to-face interviewing techniques. Interviewers were trained by Lisa Abramson of Inter-Tribal Council of Michigan. Interviewers were trained by Lisa Abramson of Inter-Tribal Council of Michigan and Favian Kennedy of Health Education and Promotion Council. Each of the potential participants, pulled from the sample of BMIC adult members residing in Chippewa County, were sent letters advising them of their potential to participate in the Bay Mills Indian Community Adult Tobacco Survey. Participants were directed to call a central phone number if they were interested in participating in the project. Participants were advised that a $10 gas card would be given in 2

exchange for their participation in the project. Interviewers then contacted participants willing to be interviewed and appointments to meet were scheduled. Challenges A number of challenges were reported by Bay Mills Community College in their implementation of the BMIC ATS. These challenges included: Lack of interest on the part of potential participants (e.g., incentive amount was not enough; tired of surveys) Return of letters to participants due to incorrect/old addresses Some of the students chosen to serve as interviewers were not members of the Bay Mills Indian Community and thus had a lack of familiarity with the community Chippewa County is geographically quite large

Demographics A total of 70 respondents participated in the Bay Mills Indian Community Adult Tobacco Survey. Fifty percent were male (n=35) and 50% percent were female (n=35). Ages of the respondents ranged from 18 to 85 years, with a mean (average) of 43.3 years, and a mode (most frequently reported) of 25years. Sixty three percent (n=44) of the respondents live with a spouse, partner or significant other. Ten percent (n=7) of the respondents did not finish high school; 14% (n=10) received either a high school diploma or a GED; 39% (n=27) completed some college and 37% (n=26) had college degrees (ranging from Associates degrees to post-graduate degrees). Seventy seven percent (n=54) report working outside the home. Respondents household incomes ranged from 1% (n=1) making less than $10,000 per annum to 23% (n=15) making less than $25,000 per annum. Twenty four percent (n=17) reported making more than $45,000 per annum.

FINDINGS

Among BMIC participants in the BMIC Adult Tobacco Survey

There is a 45% smoking prevalence rate (n=32) 44% of participants are Every Day smokers (n=31) 1% of participants are Some Day smokers (1) 73% of participants who are women of child bearing age smoke cigarettes (n=11; N=15) 51% of female participants smoke (n=18) 40% of male participants men smoke (n=14) 17% of participants currently use chew/spit tobacco (n=9)

Prevalence Rates

Respondents reported an average age of initiation to be 12.8 years, with a mode of 14. Initiation ages ranged from 5 to 25 years of age. Regular use began for the respondents at an average age of 11.5. Regular use range was 10 to 34 years with a mean of 11.5 years and a mode of 14 years. Included in the sample were 17 women of childbearing age (18-44). Of these 17 women, 73% (n=11) smoke cigarettes.

Ten percent (n=7) of the population smoke cigars either daily or some days, while 1.4% (n=1) smoke pipes, use chew/spit or dip/snuff tobacco.

Quit Methods Among those smokers who quit smoking cigarettes, cold turkey is the most popular method used followed by cessation classes and medication.

METHODS OF QUIT: 2011 Cold Turkey: 43% (n=30) Medications: Class: Patch: Nicotine Gum: 7% (n=6) 7% (n=5) 6% (n=4) 4% (n=3)

Among the 27 women who received pre-natal care while pregnant, 59% report that their medical provider talked with them about the adverse health effects of smoking on their babies

Physician and Patient Ninety six percent (n=67) of the BMIC respondents had seen a medical provider in the 12 months preceding the survey. Of those, 90%

(n=63) were asked by the medical provider if they smoked. Of those 63 individuals, 49% (n=31) were advised by the medical provider to quit smoking.

In an effort to learn about any quit assistance the medical provider may have given their smoking clients, the following questions were asked:

In the past 12 months, when a doctor, nurse, therapist, or counselor advised you to quit smoking, did they also do any of the following? Yes Prescribed or recommended a nicotine patch to help you quit smoking? (N=30) Prescribed or recommended nicotine gum to help you quit smoking? (N=30) Prescribed or recommended nasal spray to help you quit smoking? (N=31) Prescribed or recommended an inhaler to help you quit smoking? N=31) Prescribed or recommended medications like Zyban, Chantix, or nicotine lozenges to help you quit? (N=30) Suggest that you set a specific date to stop smoking? (N=30) Suggest that you use a smoking cessation class to help you quit smoking? (N=31) Suggest that you use a smoking cessation program to help you quit smoking? (N=31) Suggest that you use a smoking cessation quit line or telephone counseling service? (N=31) Provide you with booklets, videos, or other materials to help you quit? (N=30) Suggest that you use ceremonial prayer or traditional methods to help you quit? (N=31) 0% 100% (n=31) 30% (n=9) 70% (n=21) 0% 100% (n=31) 10% (n=3) 90% (n=28) 10% (n=3) 90% (n=28) 24% (n=7) 76% (n=23) 20% (n=6) 80% (n=24) <1%(n=1) 99% (n=30) 0% 100% (n=31) 7% (n=2) 93% (n=28) 17% (n=5) No 83% (n=25)

Attitudes About Clean Indoor Air Policies Sixty percent (n=42) of the respondents report that they do not allow smoking anywhere at any time inside their home. Twenty three percent (n=16) report that smoking is allowed in some places inside their home and 17% (n=2) report that smoking is allowed everywhere in their homes. In the seven days preceding the survey, 50% (n=35) report having ridden in a car where someone was smoking. With the exception of casinos and bingo halls, the respondents significantly think that smoking should not be allowed in most indoor areas. With regard to casinos and bingo halls, the majority 67% (n=47) believe that smoking should be allowed either in all areas or in some areas.
Do you think smoking should be: Allowed in All Areas In indoor work areas 1.4% (n=1) 35.7% (n=25) 60% (n=42)) 2.9% (n=2) Allowed in Some Areas Not allowed at all Did not respond

In indoor areas of restaurants 1.4% (n=1) 27.1% (n=19) 71.4% (n=50)

In indoor shopping malls

1.4% (n=1)

15.7% (n=11)

82.9% (n=58)

In indoor areas of tribal buildings

21.4% (n=15)

74.3% (n=52)

In community centers

18.6% (N=13)

77.1% (N=54)

4.3% (N=3)

In casinos or bingo halls

24.3% (N=17)

42.9% (N=30)

25.7% (N=18)

7.1% (N=5

Risk Perception

Respondents were asked questions about their perceptions of the harm caused by second-hand-smoke and use of commercial tobacco products.

Do you believe that breathing smoke from other peoples cigarettes

Yes

No

Causes heart disease in adults

57.1% (n=40)

8.6% (n=6)

Causes colon cancer in adults

24.3% (n=17)

24.3% (n=17)

Cases respiratory problems in children

95.7% (n=67)

1.4% (n=1)

Causes sudden infant death syndrome (SIDS)

35.7% (n=25)

20% (n=14)

Causes lung cancer in adults

75.7% (n=53)

5.7% (n=4)

Supplemental Questions

Findings indicate that 61% (n=43) of respondents use tobacco for ceremonial, prayer, and/or traditional reasons. Of these, 28% (n=12) use native or traditional tobacco and 63% (n=27) use commercial tobacco when using for ceremonial, prayer and/or traditional reasons. Forty seven percent of respondents (n=33) have smoked a pipe for ceremonial, prayer and/or traditional reasons and of those 33% (n=11) used native or traditional tobacco and 30% (n=10) used commercial tobacco. Twenty six per cent (n=18) report having been told that they have asthma, and 14% (n=10) still have asthma. Nineteen percent (n=13) of the respondents have diabetes and 85% of those take insulin or other medications for the disease. Thirty six percent (n=25) have been told that they have high blood pressure and of those, 72% currently take medication for the disease. Of the respondents, 80% (n=56) have had their cholesterol checked. Of the respondents, 37% (n=26) report having high cholesterol and 692% of those take medication for high cholesterol. Four percent (n=3) of the respondents have had a heart attack (myocardial infarction); 3% (n=2) report having angina or coronary heart disease, and 4% (n=3) have had a stroke.
SMOKERS WITH CHRONIC DISEASES 40% of BMIC participants with asthma continue to smoke cigarettes 33% of BMIC participants who have suffered a myocardial infarction continue to smoke cigarettes 31% of BMIC participants with high cholesterol continue to smoke cigarettes 44% of BMIC participants with high blood pressure continue to smoke cigarettes 31% of BMIC participants with diabetes continue to smoke cigarettes 66% of BMIC participants who have had a stroke continue to smoke cigarettes 0% of BMIC participants with coronary heart disease continue to smoke