American Indian

Native American

While smoking rates can vary from tribe to tribe, American Indian communities continue the trend of having the highest rates of cigarette smoking in the country. Several CDC surveys found that the current smoking rate for American Indians and Alaskan Natives is between 31% and 39%.1 The high smoking rate contributes to Wisconsin having the highest American Indian lung cancer rate in the nation, and a 50% higher mortality rate for all cancers combined when compared to whites in Wisconsin.2


Even though national tobacco cessation programs have had success with other racial/ethnic groups, quitting attempts remain relatively low among American Indians.1

Pregnant women
Nationally, pregnant American Indian women have smoked almost double the rate compared to pregnant white women. During the last three months of pregnancy, 26% of American Indian women smoke, leading to adverse pregnancy effects.3 While tailored cessation efforts are important for all pregnant women in Wisconsin, the need is especially high for pregnant American Indian women.


Nationally, American Indian high school smoking rates have dropped from 25% in 2013 to 12% in 2015. Although the rates have been decreasing, it is still above the national average of 11%.7 Early initiation of tobacco use can lead to negative effects among youth.

Traditional tobacco (or ceremonial tobacco) holds important cultural and spiritual importance to most American Indian tribes and is used for prayer.5 Ceremonial tobacco is most commonly offered by hand rather than being smoked; when ceremonial tobacco is smoked, it is never inhaled. Commercial tobacco contains thousands of chemicals that are carcinogenic, unlike ceremonial tobacco.5 The distinction between traditional and commercial tobacco is important to reflect how American colonization has impacted tobacco use among American Indians.

The symbolism and traditions of ceremonial tobacco have also been used as marketing strategies for products like Natural American Spirits and tobacco company-sponsored cultural events. These products make commercial tobacco more attractive to American Indians and contribute to high smoking rates.7


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