33% of adult American Indians and Alaska Natives are smokers--this is the highest rate of commercial tobacco use among every age, ethnic, and gender category in the U.S.⁴

Targeting American Indians for future customers, some tobacco companies use American Indian images and cultural symbols in their advertising, such as warriors, feathers, regalia and words like natural in the brand names.1 To build its image and credibility in the community, the tobacco industry funds cultural events such as powwows and rodeos.⁵

Cardiovascular disease is the leading cause of death among American Indians. Lung cancer is the leading cause of cancer death among American Indians. Tobacco use is a major risk factor for both diseases.⁵

The prevalence of smokeless tobacco use is higher among American Indians and Alaska Natives than any other ethnic group in the U.S.⁷

Current smoking among high school students at Bureau of Indian Affairs high schools is 56%3, more than double the smoking prevalence rate among all U.S. high school students.⁶

While the Indian Health Service is responsible for fulfilling the U.S. trust obligation of providing healthcare, it consistently receives between 40% and 50% of the funding required to provide minimum services.²

As sovereign nations, tribes were excluded from eligibility to receive any funds from the Master Settlement Agreement, leaving them to rely on dwindling, or in some cases nonexistent, state funding for tobacco control.

Federal, state, and local funding mechanisms often assume incorrectly that most tribes have the capacity and infrastructure to launch and maintain tobacco control activities of their own, and thereby omit tribal communities from outreach and services.

Tobacco sales are important economic venture for some tribes. Cheaper cigarettes are often accessible to American Indians on tribal lands.

It is estimated that the tobacco plant has been used in a sacred way by American Indians for over 18,000 years. Traditional tobacco is still used by many tribes--often in prayer, or gifted to elders or to people who share wisdom or prayers. While it does contain nicotine, traditional tobacco is not processed with chemicals or used in the same way as commercial tobacco so does not pose the same health risks.

In 2007, an estimated 36.4% of American Indians and Alaska Natives adults were smokers, which was signifcantly higher than other racial/ethnic groups and the national average (19.8%)⁸

References:
1. AMA (press release), National Coalition FOR Women AGAINST Tobacco Launches Defense Against the Tobacco Industry, 1999.
2. NPAIHB, Priority One: The FY2005 Indian Health Service Budget: Analysis and Recommendation, 2004.
3. CDC, Tobacco, Alcohol, and Other Drug Use Among High School Students in BIA-Funded Schools, 2001.
4. CDC MMWR Highlights, Cigarette Smoking Among Adults, United States, 2004. MMWR 2005.
5. DHHS, 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. DHHS. CDC, 1998.
6. CDC, Use of Smokeless Tobacco Among Adults, U.S., 1991.
7. 1998 Surgeon General's Report-Tobacco Use Among U.S. Racial/Ethnic Minority Groups/
8. CDC.MMWR. November 14, 2008 / 57(45); 1221-1226

American Indians and Alaska Natives and Tobacco Use