That's 52% as opposed to 2% nationally. "...research of medical charts shows 82 percent of pregnant women in the region use tobacco -- 61 percent chew iqmik [a type of smokeless tobacco, see below - Ben] or a commercial tobacco and 21 percent smoke. Nationally, the smokeless tobacco use rate for pregnant women is under 1 percent."
In the Yukon-Kuskokwim Delta region - the area referred to as "Western Alaska" in the title - an area with a predominately Yupik Eskimo population - they mix tobacco leaves with "the ash of a fungus (Phellinus igniarius) that grows on birch trees." The product, called "iqmik" is an unusually potent smokeless tobacco product. "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."
Sandi Gerjevic wrote a story about this for the Anchorage Daily News in 2001: Iqmik immersion. Yukon-Kuskokwim group, Mayo Clinic work together to help Natives kick the habit.
You can imagine the health consequences:
...smokeless tobacco is known to cause chronic hypertension and increase the risk of stroke and cardiovascular disease, along with head and neck cancers, including oral cancers.
It is possible to quit:
In her eighth month of pregnancy, a powerful craving gnawed at Carrie Enoch. She'd lie awake at night until she could no longer stand it. Then she'd rise, pinch off a tiny piece of iqmik and place it in her mouth.
While Enoch longed for the substance, the taste was strong and no longer appeased her. And she'd sometimes feel her baby stir inside her -- which was enough to make Enoch put the mixture away....
Enoch, 40, grew up in Tuntutuliak, about 49 miles southwest of Bethel. She experimented with iqmik as a child and became addicted at age 16 while attending boarding school in Bethel. She never had to buy iqmik -- it was readily available. She used the mixture routinely, well into her 30s.
"Early in the morning, wake up, chew and take a shower," she said. "Before I did anything, like chores, I had to find my iqmik first. If I was going somewhere, I had to find it. I had to have it in my pocket."
Enoch said she was motivated to quit by her pregnancy -- she wanted a "smart, healthy" baby. With the encouragement of her doctor and family members, she managed to stop using within about two weeks, although cravings tormented her for months.
"It was hard for me at first," she said. "But I did it. And anybody can do it."
Alaska Magazine carried a story on this in its September issue. Here's a web based supplement to the story: Iqmik Slideshow, showing how iqmik is made. Ash and tobacco leaves for mixing iqmik are sold in stores throughout the region. Gallon bags of the ash from burning the fungus sell for as much as $150 in some villages.
Diane Pleninger and Tom Volk write about Phellinus igniarius use among Native Americans, and particularly the Yupik: Phellinus igniarius, Iqmik, used by native Americans with tobacco. Among other things, they note:
Beautifully fashioned and decorated wood, bone and ivory boxes were made to hold punk ash or quids that still had life in them. The images of the quid boxes are courtesy of the Anchorage Museum of History and Art, donated to the museum by the Huffmon family, particularly Betty Huffmon of Goodnews Bay, Alaska, where most of these objects were collected. Just to orient you, Goodnews Bay is on the southwest coast of Alaska, just north of the Alaska Peninsula. According to Walter Van Horn at the Museum, Betty Huffmon, born in 1920, said that "everybody had a quid box" during her childhood. To possess iqmik was to show the world that you were a successful hunter with a full storehouse. You were able to take time off from subsistence activities and you were also willing to share your iqmik with others....
Meanwhile, an entrepreneur in the Y-K Delta can make $40 for an eight ounce jelly jar of punk ash. He will travel upriver and inland into birch forests to collect Phellinus igniarius conks. He will incinerate the conks in a coffee can placed in a fire, and sift the ash. In Bethel and other towns and villages, the ash will be sold in general stores in zip-lock bags, along with leaf tobacco, to customers who make iqmik....
The title quote is from the Alaska Magazine web piece.