Intertribal Life Newspaper -

ATLANTA, Ga.-A new report released recently by the Centers for Disease Control and Prevention (CDC) reveals that although significant progress has been made in reducing overall commercial tobacco product use among Americans, disparities persist, with American Indians/Alaska Natives (AI/ANs) having one of the highest cigarette smoking prevalences of all racial/ethnic groups.

The findings based on five years of studies revealed that tobacco product use was significantly higher among American Indians and Alaska Natives than among non-AI/ANs-including whites, blacks, Pacific islanders; Hispanic, Asians and multiracial groups-for any tobacco product (43.3% versus 27.7%), cigarettes (37.3% versus 23.0%), roll-your-own tobacco (7.1% versus 3.5%), pipes (1.9% versus 0.9%) and smokeless tobacco (6.6% versus 3.5%). Prevalence of cigar smoking among AI/ANs was lower than among blacks, but higher than among Hispanics and Asians.

Among the American Indian and Alaska Native category, use of any tobacco product was higher among males (49.7%), people aged 18–25 years (55.6%), people with less than a high school diploma (49.8%), people with an annual family income of less than $20,000 (50.3%), those persons who lived below the poverty level (51.3%) and those who never married (50.5%).

Some American Indian tribes have long used traditional tobacco in cultural ceremonies. However, evidence suggests that commercial tobacco products, such as cigarettes and packaged loose tobacco, are being increasingly substituted for ceremonial purposes. In addition, tobacco products are less expensive on tribal lands, which might increase tobacco access and consumption.

The tobacco industry has also been shown to target Native Americans by marketing cigarette brands with cultural icons, names and symbols belonging exclusively to this demographic.

Health consequences

American Indians and Alaska Natives have a higher risk of experiencing tobacco-related disease and death due to high prevalence of cigarette smoking and other commercial tobacco use.

Cardiovascular disease is the leading cause of death among American Indians/Alaska Natives. Lung cancer is the leading cause of cancer deaths among American Indians/Alaska Natives. Diabetes is the fourth leading cause of death among American Indians/Alaska Natives. The risk of developing diabetes is 30 to 40% higher for smokers than nonsmokers.

What are the implications for public health practice?

Addressing the social determinants of health and providing evidence-based, population-level and culturally appropriate tobacco control interventions could help reduce tobacco product use and disparities in tobacco product use among American Indians and Alaska Natives. Such interventions could include engaging Native community leaders and fostering respect for traditional/ceremonial use of tobacco as a reason for not using tobacco recreationally.

The equitable implementation of evidence-based tobacco control interventions, such as comprehensive smoke-free policies, is important to reduce tobacco product use among American Indians and Alaska Natives.

The CDC has implemented population-level strategies to help reduce disparities, including Good Health and Wellness in Indian Country, an initiative that works to reduce commercial tobacco product use, while improving nutrition, physical activity, health literacy and community-clinical linkages for Native populations.

CDC's Tips From Former Smokers tobacco education campaign uses culturally appropriate mass media campaigns to warn about the health risks of smoking. Some of this work is tailored toward racial/ethnic minorities, including the Native American populations.