Purpose: To determine the prevalence of, and the risk and protective factors associated with, tobacco product use among adolescents in Guam, a US-Affiliated Pacific Island (USAPI) territory. To examine disparities in risk and protective factors across indigenous and nonindigenous groups. Design: Quantitative; cross-sectional. Setting: Middle and high schools in Guam. Sample: The Global Youth Tobacco Survey sample included a representative sample of 2449 6th to 12th graders (71% response rate). Sample for the supplemental study included 670 middle school students (76% response rate across randomly selected classrooms). Measures: Self-reported measures of lifetime and past 30-day tobacco and betel nut use, social competence, resistance self-efficacy, risk perceptions, friend and family tobacco product use, and ease of access to tobacco products. Analysis: Multilevel logistic regression and analysis of covariance. Results: The prevalence rates of current cigarette, smokeless tobacco, and e-cigarette use among middle school students were 8%, 8%, and 25%, respectively. Ability to resist social pressure to use tobacco/betel nut use was strongly associated with lower likelihood of tobacco (odds ratio [OR] = 0.76; 95% confidence interval [CI]: 0.68-0.84) and betel nut use (OR = 0.74; 95% CI: 0.67-0.82). Indigenous Pacific Islanders scored significantly lower on protective and higher on risk factors. Conclusion: Tobacco product use rates among Guam middle school students appear to be 4 to 5 times higher than the US national average rates. There is an urgent need for developing tobacco and betel nut use prevention programs for USAPI youth that are tailored to the needs of indigenous Pacific Islanders.

Background: Betel (areca) nut is an addictive substance chewed with or without tobacco widely in Asia and the Pacific, including the U.S.-affiliated Pacific Islands (USPI). Betel nut use has been found to cause oral cancer. Research suggests that most betel nut use initiation occurs in adolescence. However, very little is currently known about the etiology of adolescent betel nut use. The present study reports findings of a formative, qualitative research conducted to understand the attitudinal and social factors associated with adolescent betel nut use in USAPI. The objective was to develop a theoretical framework of adolescent betel nut etiology that would guide the development of a prevention program. Method: Semi-structured interviews were conducted with 20 adolescent betel nut users (M age = 14.5; SD = 2.2) from Guam. Results: Findings suggested a framework of adolescent betel nut etiology in which intrapersonal, social, and environmental factors influence betel nut use behavior. Conclusions: The framework is consistent with ecological frameworks of adolescent substance use in which proximal personal and social influences on adolescent substance use occur within the context of a wider socio-cultural context conducive to adolescent substance use. Specifically, we found that beliefs such as betel nut tastes good and induces relaxation represent some of the betel nut use motives; parental permissiveness and peer and sibling use encourage betel nut use; and cultural acceptance and easy accessibility to betel nuts provide an environmental context conducive to betel nut use. Findings are discussed in the context of developing an adolescent betel nut use prevention program.

Purpose: The purpose of this paper is to explore the representation of Kanaka Maoli (Hawaiian) Hula Dance in traditional systems of representation and organization.Design/methodology/approach: This exploratory study analyzes the controlled and natural language vocabularies employed for the representation and organization of Hawaiian culture, in particular Hawaiian hula. The most widely accepted and used systems were examined: classification systems (Library of Congress Classification and Dewey Decimal Classification), subject heading systems (Library of Congress Subject Headings and authority files (Library of Congress and OCLC Authority Files), and citation indexing systems (Web of Science Social Sciences and Art and Humanities databases).Findings: Analysis of various tools of representation and organization revealed biases and diasporization in depictions of Hawaiian culture. The study emphasizes the need to acknowledge the aesthetic perspective of indigenous people in their organization and presentation of their own cultural knowledge and advocates a decolonizing methodology to promote alternative information structures in indigenous communities.Originality/value: This study contributes to the relatively limited scholarship on representation and organization for indigenous knowledge organization systems, in particular Hawaiian culture. Research suggests that access to Native Hawaiian cultural heritage will raise awareness among information professionals in Hawai’i to the beauty of Native Hawaiian epistemology.