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Sonia isaac mann preliminary findings traditional tobacco research project feb 11 2014-1

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Sonia isaac mann preliminary findings traditional tobacco research project feb 11 2014-1

  1. 1. Understanding Tobacco Use Amongst Youth in Four First Nations Funded by the CIHR and CTCRI (a partnership of the CCS, CIHR and Health Canada)
  2. 2. 2 Abstract This community research partnership explored the question of how traditional knowledge of tobacco could be used in prevention and intervention of tobacco misuse amongst First Nations Youth. In our presentation, we will review findings of our Indigenous-led five year project that involved 4 First Nations communities from across Canada. Our methodology used a decolonizing and OCAP™ compliant approach whereby each participating First Nations were involved in all aspects of research. Preliminary findings reinforce the importance of understanding tobacco as a sacred medicine in addressing disproportionate rates of smoking among First Nations Youth. As well, our findings speak to the active part that Indigenous Youth play in their own wellness, seeking cessation strategies where and when needed.
  3. 3. Outline Introduction Background Purpose Objectives Partnership Framework Model Project and Community Research Teams Methodology Key Preliminary Findings Community Action Plans 3
  4. 4. Introduction  Traditionally tobacco has been used by many First Nations for ceremonial and medicinal purposes.  However, it is well documented that the misuse of tobacco is of concern to the general Canadian population as well as to First Nations.  Health effects linked to smoking include cancer, heart disease, cerebrovascular diseases and chronic lung diseases (Physicians for a Smoke-Free Canada, 2007).  The RHS (2008/10) reported smoking rates of 33.1% amongst First Nations youth aged 12 – 17 years and 56.9% (daily and occasional smokers) amongst First Nations adults aged 18+ while smoking rates remain at 8% amongst the general Canadian population.  Smoking decreased from 2002/03 from 25.6% to 20.4% and those who quit did so in order to improve health. 4
  5. 5. Background  The lines between traditional tobacco use & commercial tobacco use have become blurred.  Tobacco misuse has become a widely defended cultural norm.  There is a lack of research on tobacco cessation with First Nations populations & a need for more in-depth research at the community level.  This study addresses some aspects of this gap in research. 5
  6. 6. Purpose  To broaden understanding of how First Nations traditional knowledge on the sacred uses of tobacco may assist with preventing tobacco misuse.  To address the unique needs of First Nations by focusing on traditional knowledge.  To build research capacity within participating First Nations. 6
  7. 7. Objectives  To share information with First Nations on culturally appropriate tobacco prevention & promising practices in intervention based on traditional knowledge.  To engage Elders in order to further our understanding of how traditional teachings about sacred tobacco can be included within Youth prevention and tobacco cessation.  To build & strengthen relationships particularly between First Nations Elders and Youth in order to better understand the prevention of tobacco misuse and culturally based cessation.  To build First Nations capacity in conducting relevant, appropriate & responsive research.  To facilitate development of national First Nations tobacco policy initiatives through the Assembly of First Nations (AFN).  To contribute to model development around community based research related to tobacco control with First Nations. 7
  8. 8. Partnership Framework Model for Community- Based Research Research Partners First Nation Community Partners Maliseet Nation at Tobique Sagamok Anishnawbek First Nation Siksika Nation Seabird Island Indian Band 8
  9. 9. Community Research Teams Maliseet Nation at Tobique Tina Martin, Community Research Partner Elaine (Arlene) Sappier, Elder Representative Carly Sappier, Youth Representative Tiffany Perley, Community Based Research Assistant Sagamok Anishnawbek First Nation Eileen Smith, Community Research Partner Delores Trudeau, Elder Representative Cheyenne Abitong, Youth Representative Audra Owl, Community Based Research Assistant Siksika Nation Tyler White, Community Research Partner Norton (Spike) Eagle Speaker, Elder Representative Armond Duck Chief, Youth Representative Richard Running Rabbit, Community Based Research Assistant Seabird Island Indian Band Edie Karacsonyi, Community Research Partner Andrew Louie, Elder Representative Emma McNeil, Youth Representative Genna Joseph, Community Based Research Assistant Project Research Team Co-Principal Investigators Dr. Sheila Cote-Meek, BScN, MBA, PhD Sonia Isaac-Mann, BSc, MSc Co-Applicants Nicole Eshkakogan, BA, MA Peter Selby, MBBS, CCFP, FCFP, MHSc, Dip ABAM Tina Martin, Community Research Partner Eileen Smith, B. Ed., MSW, RSW, Community Research Partner Edie Karacsonyi, BSW, Community Research Partner Tyler White, Community Research Partner Assembly of First Nations Barney Williams, Elder Youth Representative, Rotational 9
  10. 10. Methodology  Community based, participatory model, emphasizing capacity building and training, partnership and collaboration.  Respecting of OCAP™ (Ownership, Control, Access, Possession) principles in research with First Nations. 10 Research Cycle Sharing the Results: Dissemination Reaffirming the Vision: Developing the Research Working with the Community: Data collection and analysis Building new understandin g and knowledge: Feedback and evaluation
  11. 11. Methodology  The project used community-based research strategies working in partnership with four First Nations across Canada.  Community Research Agreements were developed and signed with each participating First Nation (respecting OCAP ™ and the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans).  Each First Nation formed a Community Research Team and appointed a Community Research Partner (co- applicant), an Elder Representative, a Youth Representative and a part-time Community-based Research Assistant. 11
  12. 12. Methods  The Community Research Teams were involved in all aspects of the research including the design & pre-testing of interview, focus group and youth survey questionnaires, as well as in the collection & analysis of data & preparation of reports.  A youth survey was added to the study at the request of the 4 First Nations.  Snowball and venue-based sampling strategies were used in the recruitment of participants.  Interviews were transcribed, coded and analyzed using qualitative thematic analysis.  Youth surveys were coded and analyzed using SPSS software.  Community feedback sessions were held in each First Nation to review draft results and validate findings. 12
  13. 13. Initial findings are based on 252 Youth aged 12 – 24 living in 3 of 4 participating First Nations. Numbers are based on those who choose to respond to given question. Age Group (Years) Male Female 12-14 31 31 15-17 28 42 18-20 41 45 21-24 15 19 Total 115 137 Key Preliminary Findings 13
  14. 14. Smoking and Tobacco misuse.  41.3% are current smokers (104 of 252 youth who answered this question), and of these 43.3% were male and 56.7% were female.  63.9% of youth surveyed indicated that they have “ever smoked” (159 of 249 who answered this question).  44% of youth reported smoking in the 30 days prior to completing the survey (111 of 252 youth). 14
  15. 15. 15 Male, 3 Male, 1 Male, 0 Male, 4 Male, 9 Male, 28 Female, 7 Female, 4 Female, 3 Female, 11 Female, 17 Female, 24 0 5 10 15 20 25 30 1-2 Days 3-5 Days 6-9 Days 10-19 Days 20-29 Days All 30 Days Number of Participants Number of Days Participants Smoked Tobacco in 30 Days Prior to Survey
  16. 16. Top Three Reported Reasons to Start Smoking Male Female Total Peer Pressure 20 51 71 Curiosity/ Experimentation 17 28 45 Family Influences 3 11 14 16  The average age at which participants tried their first cigarette was 13.  The average age participants first began to smoke daily was 13.6.
  17. 17. 17 Current Smokers Top Three Reported Reasons to Start Smoking Male Female Total Peer Pressure 15 32 47 Curiosity/ Experimentation 12 17 29 Family Influences 3 6 9
  18. 18.  94% of the 248 youth who answered this question indicate they have heard the term “second-hand smoke”.  22.7% of the 247 youth who answered this question indicate they have heard the term “third-hand smoke”.  78.3% of the 240 youth who answered this question indicate they know what traditional tobacco is.  45.6% of the 237 youth who answered this question indicate they know how to use tobacco in a traditional way. 18
  19. 19. 19 Attempts to Quit Smoking  100 youth indicate they have tried to quit smoking, including 80 current smokers (35 male and 45 female).  When asked how many times they have tried to quit, 82 youth reported 209 attempts, an average of 2.5 quit attempts per youth.  56 youth reported successful smoke free periods ranging from one month to 10 years, with the average period being 8.7 months smoke free.
  20. 20. 20 What Helped Youth to Quit Smoking What Helped Youth to Quit (top three responses) Male Female Total Knowledge of Health Effects 21 26 47 Cost 13 12 25 Social or Family Pressure 6 9 15
  21. 21. What caused you to continue to smoke? (top three responses) Smokers and Non-Smokers Current Smokers Stress-work, personal, relationships 34 27 Others smoking around me 16 9 Cravings 15 15 21 Challenges
  22. 22. 22 Probably Impossible Very difficult Fairly Difficult Fairly Easy Very Easy Age Group 12 - 14 9 1 3 7 6 Age Group 15 - 17 1 1 3 17 30 0 5 10 15 20 25 30 35 Access to Cigarettes - 12 - 17 Year Old Youth
  23. 23. 23 Source of last cigarette smoked (top three responses) Youth 12 - 24 Youth 12 - 17 Friend 68 37 Commercial Vendor 58 4 Family Member 11 5 Access to Cigarettes  When asked, 88.8% of 147 youth who answered this question thought it would be fairly or very easy to access cigarettes.
  24. 24. Exposure to Commercial Tobacco  80.6% of the 247 youth who answered this question indicate that their parents or guardians smoke.  96 of the 104 current smokers report a total of 217 smokers reside in their homes – an average of 2.3 smokers per household.  200 of 252 participants report a total of 414 smokers in reside in their homes – an average of 2.1 smokers per household. 24
  25. 25. Program Percentage of youth/# of youth Effectiveness [1-5 with 1 meaning Not Very Effective, 3 is Effective and 5 is Very Effective] Smoking cessation 32 = 12.7% 2.44 Support groups 30 = 11.91% 2.19 Nicotine Replacement 32 = 12.70% 2.38 Addiction Counselling 33 = 13.1% 2.52 Education Workshops 52 = 20.64% 3.09 Other 9 = 3.58% 2.14 Total 224 2.87 Youth Participation in Tobacco Related Programs and Services… 25
  26. 26. Not Concerned At All Not Very Concerned Somewhat Concerned Very Concerned Number 42 64 104 36 Percentage 17.07% 26.02% 42.28% 14.63% 0 20 40 60 80 100 120 Participant Level of Concern About Smoking in Their Communities 26
  27. 27. 27 Not Concerned At All Not Very Concerned Somewhat Concerned Very Concerned Male 10 12 24 13 Female 14 16 28 10 0 5 10 15 20 25 30 Participant Level of Concern About Smoking in Their Communities by Gender
  28. 28. 28 Not Concerned At All Not Very Concerned Somewhat Concerned Very Concerned 12-14 10 12 24 13 15 - 17 14 16 28 10 18 - 20 11 26 40 8 21 - 24 7 10 12 5 0 5 10 15 20 25 30 35 40 45 Participant Level of Concern About Smoking in Their Communities by Age Group
  29. 29. 29 Not Concerned At All Not Very Concerned Somewhat Concerned Very Concerned Non-Smoker 24 30 60 29 Smoker 18 34 44 7 0 10 20 30 40 50 60 70 Participant Level of Concern About Smoking in Their Communities by Smoking Status
  30. 30. 30 Limitations  Length of the survey may have contributed to unanswered questions.  Literacy and/or comprehension may have been issues.  Competing priorities in the community.
  31. 31. Dr. Sheila Cote-Meek Associate Vice-President, Academic & Indigenous Programs Laurentian University Ramsey Lake Road Sudbury, ON P3E 2C6 (T) 675-1151 ext. 3429 Email: scotemeek@laurentian.ca Sonia Isaac-Mann, BSc., MSc. Associate Director of Health Safe, Secure and Sustainable Communities Assembly of First Nations 55 Metcalfe Street Ottawa, ON K1P 6L5 Tel: 613-241-6789 ext.358 Fax: 613-241-5808 Email: soniaim@afn.ca 31

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