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Commercial Tobacco Use in American Indian and Alaska Native Populations


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Many tribes use tobacco in a traditional way for ceremonial or medicinal purposes, such as healing ceremonies and offerings. Traditional tobacco use differs from commercial tobacco use. Commercial tobacco products are addictive and contain thousands of chemicals that harm the body due to regular use.

How common is commercial tobacco use in AI/AN populations?

Since 1978, American Indians/Alaska Natives (AI/AN) have had the highest use of commercial tobacco compared to people of other races or ethnicities.

Among AI/AN populations:

  • 1 in 2 young adults aged 18 to 25 years use tobacco
  • 1 in 5 adults aged 18 and over smoke cigarettes
  • 1 in 12 adults aged 18 and over use smokeless tobacco
  • 1 in 6 women smoked during pregnancy

Smoking prevalence is highest in the Northern Plains region (Iowa, Michigan, Minnesota, Montana, Nebraska, North and South Dakota, Wisconsin, and Wyoming)

What are the health risk of tobacco use?

The use of commercial tobacco affects nearly every organ in the body and can have serious health effects leading to disability and premature death. Smoking can lead to an increased risk of developing lung cancer, diabetes, heart disease, stroke, and chronic obstructive pulmonary disease (COPD).

Health risks also exist among AI/AN women using commercial tobacco products before, during, and after pregnancy. Some of these risks include fertility problems, premature birth, birth defects, and sudden infant death syndrome (SIDS).

Why should I quit?

Stay healthy by not using commercial tobacco products and be a positive role model for your loved ones, family, and community.

  • 2 weeks after quitting, your breathing improves
  • In 1 year, your risk for a heart attack is cut in half
  • In 5 years, your risk for a stroke is the same as a person who never smoked
  • In 10 years, your risk of lung cancer is reduced by half
  • To lower your cholesterol levels
  • To lower your risk of developing type 2 diabetes
  • To lower your risk for gum disease
  • To avoid exposing your friends and family to secondhand and thirdhand smoke

How do I quit?

FDA-approved smoking cessation products can help you quit. Talk to your doctor or pharmacist to find a treatment that is right for you.

  • Over-the-counter nicotine replacement medications may come in the form of skin patches, gum, lozenges, inhaler, or nasal spray.
  • Prescription products are available through a prescription from your health care provider. These products may come in the form of pills, inhaler, or nasal spray.

Where can I learn more?

The Indian Health Service has information on tobacco prevention at: www.ihs.gov/forpatients/healthtopics/TobaccoPrevention.

For resources to help you quit, visit: www.smokefree.gov.

To speak with a smoking cessation counselor, call the Centers for Disease Control and Prevention at: 1-800-Quit-Now (784-8669).

For more information on health equity, visit www.fda.gov/healthequity.

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Additional Languages

We hope that you find these translations useful. While the agency has attempted to obtain translations that are as faithful as possible to the English version, we recognize that the translated versions may not be as precise, clear, or complete as the English version. The official versions of these materials are the English versions.


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