Surgeon General's Report on Women and Smoking
American Indian or Alaska Native Women and Smoking

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Smoking Prevalence Among American Indian or Alaska Native Women

• In 1998, smoking prevalence was highest among American Indian or Alaska Native women (34.5 percent), intermediate among white women (23.5 percent) and black women (21.9 percent) and lowest among Hispanic women (13.8 percent) and Asian or Pacific Islander women (11.2 percent).

• Reported smoking rates have varied widely among American Indian tribal affiliations and by geographic location. The type of cigarettes, manner of inhaling, and numbers of cigarettes smoked vary widely. Fifty-four percent of American Indians live in urban settings, and another large percentage live on rural reservations.

• Data from 1994-1996 show that smoking prevalence was the highest among American Indian or Alaska Native women living in the northern plains (43.5 percent) and in Alaska (40.6 percent), intermediate among women living in the East (33.4 percent) and the Pacific coast (30.6 percent), and lowest among women living in the Southwest (18.6 percent).

• Current Population Survey data for 1992-1993 showed a higher smoking prevalence among Alaska Native women (46 percent) than among American Indian women in the continental United States (35 percent).

• The prevalence of heavy smoking (25 or more cigarettes per day) among American Indian or Alaska Native women was unchanged from 1978-1980 and through 1994-1995.

• Data for the combined years 1978-1980 through the combined years 1992-1993 demonstrate that American Indian and Alaska Native women consistently smoked fewer cigarettes than did men.

Smoking Prevalence Among Young American Indian or Alaska Native Women

• Published data show that among American Indian or Alaska Native women aged 18-34 years there has been no significant change in current smoking prevalence from 1978-1980 (53.3 percent) through 1994-1995 (48.0 percent).

Smoking Prevalence Among American Indian or Alaska Native Girls

• The 1997 Youth Risk Behavior Survey showed that the percentage of girls who had ever tried a cigarette was substantially higher among high school students who attended schools that were funded by the Bureau of Indian Affairs (93.5 percent) than among high school girls overall (69.3 percent).

• Data on current smoking among girls of racial and ethnic groups are limited and range in prevalence. Studies indicate that, among high school-aged girls, smoking prevalence for American Indian or Alaska Native girls ranges from 9 percent to 65 percent.

• Survey data from 1990-1994 indicate smoking prevalence among high school senior girls was highest among American Indian or Alaska Natives (39.4 percent) and whites (33.1 percent), intermediate among Hispanics (19.2 percent) and Asian or Pacific Islanders (13.8 percent), and lowest among blacks (8.6 percent).

Smoking and Pregnancy

• Smoking prevalence during pregnancy differs by age, race and ethnicity.

• The prevalence declined in all age, racial and ethnic groups from 1989 through 1998.

• Smoking prevalence was consistently highest among women aged 18 through 24 years, lower among girls, and generally lowest among women aged 25-49 years.

• Tobacco use during pregnancy by American Indian or Alaska Native mothers was higher than in any other racial or ethnic group, but the prevalence decreased from 23.0 percent in 1989 to 10.2 percent in 1998.

• The effects of smoking on birth weight appear to be similar among various racial groups in the U.S. In one study, lower average birth weight has been reported among infants of Alaska Native smokers compared with nonsmokers of the same race or ethnicity.

Smoking Cessation Among American Indian or Alaska Native Women

• No studies have addressed factors that may influence smoking cessation among American Indian or Alaska Native women specifically.

• Smoking cessation among women varies by age, race and ethnicity, level of education, and income.

• Data from 1997-1998 show the percentage of smokers who had quit smoking was lower among American Indian or Alaska Native women (37.2 percent) and Hispanic women (43.1 percent).

• Among American Indian or Alaska Native women, the percentage of smokers who had quit smoking varied by region of the United States.

• White female girls (27.9 percent) were more likely than black (22.5 percent), Hispanic (23.5 percent), or Alaska Native and American Indian (15.7 percent) girls to have been counseled by a health care provider on cigarette smoking.

Smokeless Tobacco Use

• The prevalence of use of smokeless tobacco among girls and women is low and remains considerably lower than among boys and men. Use of smokeless tobacco is higher among black women and American Indian or Alaska Native women, women with fewer than 12 years of education, and women who live either in rural areas or in the South.

• Among girls, whites, blacks, and Hispanics are equally likely to use smokeless tobacco, but use is thought to be higher among American Indian or Alaska Native girls.

Publication date: 2001