Jump to full article: Anchorage (AK) Daily News, 2001-11-20
Author: Sandi Gerjevic
Intro: As a nicotine-dependence counselor at the Yukon-Kuskokwim Health Center in Bethel, Enoch often shares the story of how she struggled to stop using iqmik after learning she was pregnant nearly a decade ago.
What is iqmik?
That's the Yupik word for a mixture of long-cut, fire-cured Kentucky tobacco and the ash of a fungus (Phellinus igniarius) that grows on birch trees in the Y-K Delta. Locals mix ash from the fungus, commonly called "punk ash," with tobacco for chewing. Often, they pre-masticate the mixture and place it in a small box, where it is shared with others, including children and sometimes teething babies. If birch fungus is not available, they might use the ash of alder or willow.
The practice is not new. European traders introduced tobacco to Natives in the Y-K Delta in the 1700s. By the 1800s, its use was widespread. No one is sure how long Natives have used iqmik, but it is prevalent in the region.
Users believe iqmik tastes better and is healthier than commercial chewing tobacco because it has no additives. Researchers estimate iqmik users outnumber commercial tobacco users 2-to-1.
But iqmik is actually more detrimental, said Caroline Cremo Renner, director of nicotine research and control for YKHC. She called the "high" or "buzz" users get a form of nicotine poisoning. Researchers believe the ash raises the pH level in the mouth, which increases the dose and enhances delivery of nicotine to the brain. In effect, the user is freebasing nicotine.
Overall, the smokeless tobacco use rate among Y-K Delta Alaska Natives is 52 percent versus 2 percent nationally. . .
Renner called tobacco use in the region a "pediatric epidemic." In research for a masters thesis, she found iqmik use common among teens and children as young as 5. Tobacco contributes to poor oral health, and some users have lost their teeth in adolescence, she said. Because Yupiks sometimes name babies for someone who has recently died, infants are occasionally given iqmik, in belief their namesake would still be craving it.
Even more disturbing is that YKHC research of medical charts shows 82 percent of pregnant women in the region use tobacco -- 61 percent chew iqmik or a commercial tobacco and 21 percent smoke. Nationally, the smokeless tobacco use rate for pregnant women is under 1 percent. . .
Mayo Clinic staffers have traveled to Bethel four times this year, and senior leadership officials of the regional hospital in Bethel have been to the Mayo Clinic. Hurt said Mayo Clinic staffers also met with the Alaska Native Health Board in Anchorage.
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