Full Circle: A Holistic Cessation Intervention Serving American Indians in Oklahoma Sally Carter, MSW, Oklahoma State Department of Health; Cynthia Tainpeah, RN, Muscogee Creek Nation; Linda Eakers, CPM, MPH, Oklahoma State Department of Health; Laura Beebe, PhD, College of Public Health, University of Oklahoma; Diana Corunoyer, Med, Oklahoma City Inter-Tribal Health Board For many years, rates of tobacco abuse among American Indian youth and adults have been much higher than rates of any other subgroup in Oklahoma. Also of serious concern, U.S. American Indians make fewer smoking cessation attempts as compared to other racial/ethnic groups, and American Indians experience more disease and disability as a result of the abuse of commercial tobacco. The Second Wind program is designed specifically to help American Indians (wa-ce-nvl-ke) adult smokers to stop smoking and remain smoke free. It provides information about smoking, practical counseling, problem solving and social support. This program is designed to be used in six one-hour group sessions, meeting every two weeks for a total of three months. Oklahoma Tobacco Helpline Quit Coaches® have received training on the traditional use of tobacco. In follow-up evaluation surveys conducted by the University of Oklahoma, College of Public Health, American Indian participants are asked to not report any traditional or ceremonial use in their reporting of quit status. Key Findings from Evaluation of the Oklahoma Tobacco Helpline · Since its launch in August 2003, the Oklahoma Tobacco Helpline has provided cessation services to nearly 3,700 American Indians in Oklahoma. · Among registrants who identified themselves as “American Indian,” 69% reported being an enrolled member of a tribe. Tribal members from 33 of the 39 federally recognized tribes in Oklahoma have utilized the Helpline. In addition, numerous other tribes were represented by Helpline registrants, including for example, Sioux, Blackfeet, Chippewa, and Oneida. · The majority of American Indian Helpline callers were female, between the ages of 25 and 54, high school graduates, or long-term, heavy tobacco users. These characteristics are similar to what is observed for all Helpline registrants. · The majority (71%) of American Indians who call the Helpline for quitting assistance choose to receive the multiple-call program, which consists of a series of four follow-up telephone-based sessions over a three to four month period. · Since September 2004, when nicotine replacement therapy (NRT), including patches and gum, became available through the Helpline, 77% (1871) of the American Indians participating in the multiple-call program also received NRT. This is slightly higher than the roughly 70% of all Helpline registrants who participate in the multiple-call program and receive NRT. NRT is available through the Helpline only to the uninsured and those on Medicare who are enrolled in the multiple-call program. · Satisfaction with services among American Indian participants from August 2003 through June 2006 was very high, with 93% reporting being satisfied with the Helpline. This satisfaction rate is similar to what is reported by all Helpline participants. · At the 4-month follow-up survey, 41.3% of American Indian participants receiving the multiple-call Helpline program report not smoking for 30 days or longer. About seven months after registering with the Helpline, more than one- third of American Indian participants who receive the multiple-call program report 30-day abstinence (36.7%). This measure of quit success does not include the use of tobacco for traditional or ceremonial purposes. The quit rates reported here far exceed the quit rates for “cold turkey” (approximately 5%). The Oklahoma Tobacco Helpline is funded by the Oklahoma Tobacco Settlement Endowment Trust, The Oklahoma State Department of Health and the Centers for Disease Control and Prevention. The Native American Tobacco Education Network was established in 2006 to maintain and mobilize community initiatives toward tobacco prevention in Native communities across Oklahoma. Vision: To educate all people on the differences between commercial and traditional tobacco usage to create a commercial tobacco free nation. Mission: Eliminating commercial tobacco marketing and usage through a statewide education and advocacy campaign in order to reduce tobacco related diseases and promote a healthier nation. Tobacco use among American Indians is a complex issue. Tobacco has held an important role in cultural and spiritual life, and continues to serve ceremonial, religious and medicinal functions in many tribes. It is important to recognize the positive social context in which tobacco is viewed by many American Indians. Tobacco control efforts, including cessation services, must emphasize the distinction between traditional, sacred use of tobacco and recreational use of commercial tobacco by individuals. INTRODUCTION TRADITIONAL USE OF TOBACCO OKLAHOMA TOBACCO HELPLINE SECOND WIND – SMOKI NG CESSATION CURRICULUM NATIVE AMERICAN TOBACCO EDUCATION NETWORK Cigarette Smoking Among Adults in Oklahoma Oklahoma has one of the highest percentages of smoking- related deaths in the nation. One in four Oklahoma adults currently smoke cigarettes. Two in three smokers are seriously thinking about quitting. Smoking rates are significantly higher among American Indians. Prevalence of Current Smokers: 34% American Indian 25% White 25% African American 22% Hispanic Smoking Related Death Data Source:Centers for Disease Control and Prevention. State Tobacco Activities Tracking and Evaluation (STATE) System. Prevalence Data Sources: The Behavioral Risk Factor Surveillance System and the Adult Tobacco Survey. Oklahoma Tobacco Helpline Data Sources: Dr. Laura Beebe, College of Public Health, University of Oklahoma