Cigarettes were introduced around the mid-1700s. By the mid-1900s, cigarette smoking became the most popular way to use tobacco. Smokeless tobacco has been around for a longtime but started to increase in use in the 1970's and early 1980's when advertising increased and people thought smokeless tobacco was a safe alternative to smoking.

In the United States, it has been estimated that about 7.8 million people, 12 years and older currently use smokeless tobacco regularly.

Smokeless tobacco and especially chewing tobacco, in Alaska is called "iqmik". But in our days, iqmik is used in anti-tobacco advertisement for to discourage people to use smokeless tobacco.
Statistics show that Alaska is a region which has the highest number of people using smokeless tobacco.

Moses Tulim and Kay Ashton, which work for the American Lung Association of Alaska, are the chair people of the leading committee of the Alaska Tobacco Control Alliance. Their main goal is to reduce the rates of tobacco use in their areas.

All anti-tobacco ads, laws, and smoking quit lines and programs, are some of the main attempt to lower Alaskans death rates from lung cancer. More than 500 Alaskans die annually from smoking and 120 more from secondhand smoke.

Tulim reported that: "This spring, we lost a lady to lung cancer who left behind a large family. The cost of losing a mother and sister can never be replaced."

But there are no statistics for the number of deaths attributable to smokeless tobacco, researchers said.

 Tulim added: "Before there were TV ads about the dangers of smoking and we were never part of it. Now we are as Alaska Natives in partnership to creating a healthy tobacco free environment."
Tulim is pleased with the changes he has seen in Bethel where public buildings have been smoke free for the past decade.

In conclusion researchers reported that a price can be put on a pack of cigarettes or a pack of smokeless tobacco products, but the social and emotional price of loving a loved one is innumerable.