Smoking, Race and Ethnicity: Tobacco Use and Native Americans

Due to the cultural significance of tobacco in Native American communities, tobacco use and Native Americans are inexorably linked, and natives generally have higher smoking rates and lower quitting rates than most Americans. Helping more Native American smokers quit could substantially reduce the damage done by tobacco across the country.

Native Americans have a special relationship with tobacco. With numerous ceremonial uses for tobacco and a deeply ingrained cultural tradition, among all of the racial and ethnic groups in the U.S., Native Americans have a particularly big problem with smoking and comparatively less motivation to quit. Tackling this issue isn’t easy, but the link between tobacco use and Native Americans causes unnecessary disease and death across the population, so cutting smoking rates in their communities is a huge priority.

Tobacco Use and Native Americans: The Statistics

American Indians and Alaska Natives have the highest smoking rates out of all racial and ethnic groups in the U.S., with 21.9 % of adults smoking tobacco. In comparison, only 7 % of non-Hispanic Asians, 10.1 % of Hispanics and 16.6 % of Caucasians smoke. In 2015, according to CDC smoking statistics, 15.1 % of U.S. adults were classed as current smokers. For tobacco use and Native Americans, this means smoking rates are 45 % higher in the subpopulation than in the general population.

The specific forms of smoking and patterns of smoking also differ between Native Americans and non-natives. For example, Native Americans and Alaska Natives are more likely to be “light” smokers (defined as smoking less than 15 cigarettes per day) than non-natives. However, they’re also more likely to smoke cigars and pipes than other racial or ethnic groups, and they’re also more likely to use smokeless tobacco.

The Challenges Presented by Ritual Tobacco Use

Many people know about the link between tobacco use and Native Americans through knowledge of their rituals and beliefs. Native Americans believe that the “manidog” (the spirits) love tobacco, and consequently it is used in most rituals and ceremonies in native communities. The manidog are offered tobacco in dry form or in the form of smoke from a pipe, and many offerings are left in various places during the course of hunting and gathering.

This presents a big challenge for anybody hoping to reduce smoking in Native American communities. For most groups of smokers, knowledge of the multitude of risks posed by smoking is enough to encourage quitting, but when it’s deeply tied to religious and cultural traditions, completely eliminating the habit is unlikely. It’s important to point out that there are differences between tobacco used for ritual purposes and that sold commercially, but the attitudes to ritual tobacco appear to impact attitudes to commercial tobaccos too.

Despite all of this, though, there is some cause for hope in that most Native American smokers do still want to kick the habit.

Native Americans and Smoking Cessation

According to the CDC, 52.1 % of Native American and Alaska Native smokers want to quit. However, this rate is much lower than that for other races. For example, 74.1 % of African-American smokers want to quit, and aside from Native Americans, the lowest rate is among Latino/Hispanic smokers, of whom 58.4 % want to quit. As you’d expect after learning this, the actual rates of quitting are lower in Native Americans and Alaska Natives than in other racial and ethnic groups.

Lower Prices and Fewer Limitations on Smoking

One additional problem for people hoping to break the link between tobacco use and Native Americans is the more relaxed rules when it comes to smoking in Native American communities. For example, tobacco sold on tribal land isn’t ordinarily subject to the usual national and state-level taxes on tobacco, which reduces the deterrent effect that prices can have on cigarette consumption.

However, lax rules like this are due to the cultural significance of smoking for Native Americans, so it isn’t a problem that can be easily rectified.

Reducing Tobacco Use Among Native Americans

The challenge presented by the link between tobacco use and Native Americans isn’t an easy one to overcome, but there are many steps that can be taken at the social and individual levels to help bring the smoking rate down. Smoking cessation programs and educational efforts designed to promote quitting should be tailored to native populations, and efforts should be made to raise the price of tobacco to discourage smoking, especially among youth.

Individual Native American smokers can quit using the same methods available to any other smokers. However, due to the cultural significance of tobacco for native peoples, a non-abstinence dependent approach like encouraging the use of smokeless tobacco may be the best strategy. Although it may be preferable to some to stop all tobacco use, smokeless tobacco reduces health risks while still allowing individuals to use tobacco in some form.

Tobacco use among Native Americans may present additional challenges for anti-smoking groups, but a focus on harm reduction could reduce the burden of tobacco-related disease while still respecting cultural differences in attitudes to tobacco.