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American Indians and
Alaska Natives and Tobacco
Health Effects |
Cigarette Smoking
Prevalence | Cigarette Smoking
Behavior | Prevalence of other
forms of tobacco use | Tobacco Industry
Influence | References
Approximately 2 million
American Indians and Alaska Natives live in the United States. Since July
1, 1990, the U.S. population of American Indians and Alaska Natives has
increased by 10.4%. The number of American Indians and Alaska Natives is
expected to increase steadily to 2.4 million in 2000, 3.1 million in 2020,
and 4.4 million in 2050. Major subgroups in this population are American
Indians, Eskimos, and Aleuts. Most American Indians and Alaska Natives
have settled across the country; the largest percentage resides in
Oklahoma (13%).1 Although many tribes consider tobacco a sacred
gift and use it during religious ceremonies and as traditional medicine,
the tobacco-related health problems they suffer are caused by chronic
cigarette smoking and spit tobacco use. Because of the cultural and
geographic diversity of American Indians and Alaska Natives, tobacco use
often varies widely by region or subgroup.2
- Nationally, lung
cancer is the leading cause of cancer death among American Indians
and Alaska Natives.2
- Smoking-attributable
deaths from cancers of the lung, trachea, and bronchus were slightly
higher among American Indian and Alaska Native men (33.5 per
100,000) and women (18.4 per 100,000) than those among Asian
American and Pacific Islander men (27.9 per 100,000) and women (11.4
per 100,000) and Hispanic men (23.1 per 100,000) and women (7.7 per
100,000), but lower than rates among African American men (81.6 per
100,000) and women (27.2 per 100,000) and white men (54.9 per
100,000) and women (27.9 per 100,000).2
- Cardiovascular
disease is the leading cause of death among American Indians and
Alaska Natives, and tobacco use is an important risk factor for this
disease.2
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Data from the
1997 National Health Interview Survey show that among the five major
racial and ethnic populations adult smoking prevalence was highest
among American Indians and Alaska Natives (34.1%) followed by
African Americans (26.7%), whites (25.3%), Hispanics (20.4%), and
Asian Americans and Pacific Islanders (16.9%).3
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In 1997, 37.9% of
American Indian and Alaska Native men smoked, compared with 27.4% of
white men. The smoking rate among American Indian and Alaska Native
women was 31.3% compared with 23.3% among white women.3
Smoking rates and
consumption among American Indians and Alaska Natives vary by region
and state. Smoking rates are highest in Alaska (45.1%) and the North
Plains (44.2%) and lowest in the Southwest (17.0%). The prevalence
of heavy smoking (25 or more cigarettes per day) is also highest in
the North Plains (13.5%).2
Since 1978, the
prevalence of cigarette smoking has declined for African American,
Asian American and Pacific Islander, Hispanic, and white women of
reproductive age (18–44 years), but not for American Indian and
Alaska Native women. In 1994–1995, the rate of smoking among
American Indian and Alaska Native women of reproductive age was
44.3%, compared with white (29.4%), African American (23.4%),
Hispanic (16.4%), and Asian American and Pacific Islander (5.7%)
women of reproductive age.2
Aggregated 1990–1994
Monitoring the Future Survey data show that racial/ethnic smoking
prevalence is highest among American Indian and Alaska Native high
school seniors (males, 41.1%; females, 39.4%) followed by white high
school seniors (males, 33.4%; females, 33.1%), Hispanics (males,
28.5%; females, 19.2%), Asian Americans and Pacific Islanders
(males, 20.6%; females, 13.8%), and African Americans (males, 11.6%;
females, 8.6 %).2
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- Compared with
whites, American Indians and Alaska Natives smoke fewer cigarettes
each day. In 1994–1995, the percentage of American Indians and
Alaska Natives who reported that they were light smokers (smoking
fewer than 15 cigarettes per day) was 49.9%, compared with 35.3% for
whites.2
- American Indian
and Alaska Native lands are sovereign nations and are not subject to
state laws prohibiting the sale and promotion of tobacco products to
minors. As a result, American Indian and Alaska Native young people
have access to tobacco products at a very young age.4
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- Aggregated
National Health Interview Survey data from 1987 and 1991 show that
5.3% of American Indian and Alaska Native men smoked cigars,
compared with 4.8% of white men and 3.9% of African American men.2
- Pipe smoking
prevalence was higher among American Indians and Alaska Natives
(6.9%), compared with whites (2.9%), African American (2.4%), and
Asian Americans and Pacific Islanders (2.3%), who smoked pipes at
nearly similar rates.2
- Among men and
women combined, the use of chewing tobacco or snuff was 4.5% among
American Indians and Alaska Natives, compared with 3.4% for whites,
3.0% for African Americans, 0.8% for Hispanics, and 0.6% for Asian
Americans and Pacific Islanders.2
- The use of
smokeless tobacco among American Indian and Alaska Native men varies
by state and region. The prevalence among men is highest in the
Northern Plains (24.6%) and lowest in the Pacific Northwest (1.8%).2
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- To build its image
and credibility in the community, the tobacco industry targets
American Indians and Alaska Natives by funding cultural events such
as powwows and rodeos.2
- The tobacco
industry commonly uses cultural symbols and designs to target
racial/ethnic populations that include American Indians and Alaska
Natives. American Spirit cigarettes were promoted as
"natural" cigarettes; the package featured an American
Indian smoking a pipe. In addition, certain tobacco product
advertisements have used visual images, such as American Indian
warriors, to target their product.2
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1. United States
Department of Commerce, Bureau of the Census. U.S. Census Facts for Native
Americans http://www.census.gov./population/estimates/nation/intfile3-1.txt,
October 1997.
2. U.S. Department of
Health and Human Services. Tobacco Use Among U.S. Racial/Ethnic
Minority Groups —African Americans, American Indians and Alaska
Natives, Asian Americans and Pacific Islanders, and Hispanics: A Report
of the Surgeon General. Atlanta: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, 1998.
3. Centers for
Disease Control and Prevention. Cigarette smoking among adults–United
States, 1997. MMWR 1999; 48: 993-6.
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