State tribes taking steps to snuff out smoking
Sometimes, when her cigarette craving is at its worst, Beatrice Komotios leaves her office at a downtown Seattle women's shelter, buys an...
Seattle Times medical reporter
Sometimes, when her cigarette craving is at its worst, Beatrice Komotios leaves her office at a downtown Seattle women's shelter, buys an apple at a nearby store and walks around the block munching on it.
Other times, she relies on other smoking quitters who can relate to her jitters and cheer her on. Or she visits a nurse counselor at the Seattle Indian Health Board, who is her rock.
"To lay down cigarettes is like starting a new life," Komotios says. "I'm saying, 'Now I'm going to take care of me.' "
Komotios is but one of millions of Americans every year who undertake one of life's most difficult battles — quitting tobacco. But as a Native American of Chippewa and Cree heritage, she is part of a much smaller group. American Indians and Alaska Natives have significantly higher rates of smoking than the rest of the population — and many pay heavily with their health.
Now most of Washington state's 29 federally recognized tribes and urban Indian communities are tackling it head-on. Armed with more than $900,000 in annual state funds, they are conducting programs ranging from counseling to teen conferences to prevent or eliminate tobacco use.
The money comes from the state tobacco tax and from what is projected to be $4.2 billion over 25 years awarded to Washington state as part of a 1998 national settlement against tobacco companies. Native tobacco programs sometimes combine funds and resources designated just for them and those for the state's overall tobacco-prevention and -control programs.
For Komotios, 48, it adds up to what she thinks is her first decent chance at quitting since she started smoking at 15. She now has access to nicotine patches and, perhaps most important, the counselor, Beverly Price, who "makes me want to keep on trying."
More lung cancer
In Washington, about 37 percent of adult Indians and Alaska Natives smoke, double the rate of the rest of the adult population. And nearly one-fourth of Indians and Alaskan Natives in the 10th grade smoke, compared to 15 percent of all sophomores in the state, according to the state Department of Health.
Among native people, the incidence of lung cancer, which is almost always fatal, is 82 per 100,000 population, 20 percent higher than in the total state population. The cardiovascular-disease death rate is 186 per 100,000, about 42 percent higher than in the total population.
While tobacco can be an important part of the spiritual and ceremonial life of native people, tribal leaders say that doesn't mean habitual use and spreading secondhand smoke to children and nonsmokers.
Thus, tribes have dubbed an anti-smoking campaign "Breathe Life Into Our Traditions." The tagline: "Pass on our traditions, not secondhand smoke."
Targeting the young
As in many anti-smoking efforts, young people are a key target.
One day last month, at the Lower Elwha Klallam Tribal Center near Port Angeles, teenage girls clustered around two preserved pig lungs, one of the star attractions of a two-day conference for Indian youth, featuring speakers from the American Lung Association, American Cancer Society and the tribe.
One healthy, pink lung easily inflated; the other, chemically treated to resemble tobacco damage, was brown and only partly filled with air.
"It's really squishy and gross!" Krista Johnson, 12, said of the damaged lung. "And nobody will like you smoking because you'll have rotten teeth."
Aid for adults, too
Tribal tobacco programs go after adult smokers, too.
Every tribe has its own approach, but projects range from tobacco-prevention booths at hundreds of events, to holding health conferences and offering individual counseling, said Jennifer Kovarik, a tobacco-prevention expert for the Northwest Portland Area Indian Health Board.
At a recent Seattle conference on cancer and native people, artists showed off work that eventually will be used to promote cancer-prevention efforts. The meeting was sponsored by Native People for Cancer Control, a collaboration of native health workers, the University of Washington and Fred Hutchinson Cancer Research Center to improve cancer education, training and research.
Chholing Taha, a Tacoma artist of Cree and Iroquois heritage, said her vivid painting, "Octopus Woman and Crow," uses a traditional Coast Salish story and cancer statistics to illustrate both the allure and danger of smoking.
In the story, Crow ignores warnings from other animals that a monster lurks at low tide. The haughty bird meets Octopus Woman, who flatters him but then envelopes him in her tentacles and consumes him. In Taha's painting, a blue bird represents former smokers who escape the monster, which represents cancer. But a yellow one is ensnared in the tentacles.
"Cancer, in particular, can be seen as a very intelligent, formidable opponent, and so there may be a belief among some healers, out of respect to cancer's power, that you can't call its name casually," Taha said.
"Art takes you out of the picture and creates a safe learning environment. Art gives a third voice, and listening is through a third ear — the heart."
Back at the Lower Elwha Klallam Tribal Center, another warning is more direct. An entrance sign tells people not to smoke near the building — or in front of children.
"Most people abide by it," said Rebecca Winn, the tribe's tobacco-program coordinator. "We don't want anyone to use tobacco. ... When they do, they're [also] being a bad influence on our kids."
Warren King: 206-464-2247 or firstname.lastname@example.org
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