Tobacco Treatment Specialist Training copy

Carl started chewing iqmik at four years old when he premasticated tobacco and ash for his grandfather and father. Everyone in his village chews iqmik and he was raised with it and no negative cultural connotations were involved with its use. In fact, one of the gifts Carl received at his birth was iqmik.

All of his siblings and relatives have chewed iqmik but Carl has noticed over the years that most of them have quit, moved onto cigarettes, or have become ill. Carl is still ambivalent about the negative use of iqmik but has been contemplating quitting since his father's death from heart attack. However, he has started chewing more since his father’s death, his mother's illness (forcing her to move in with him as the caretaker), and because his job has become more demanding. He previously chewed 4-5 times per day. Now he 10 chews times a day.