Tobacco and American Indians/Alaskan Natives

Respect • Tradition • Humility • Patience • Harmony with nature

There are many unique health risks associated with Tobacco and American Indians/Alaskan Natives.

Tobacco Use and Health

  • 23.2 percent of American Indians/Alaska Natives (AI/AN) are current smokers
  • 29.7 percent of AI/AN men smoke, which is the highest smoking prevalence among all racial/ethnic subgroups
  • 23.1 percent of AI/AN youth (ages 12-17) smoke, which is the highest smoking rate compared to any other group
  • Cardiovascular disease is the leading cause of death among AI/AN, and tobacco use is an important risk factor
  • Cancer is the second leading cause of death for individuals 45 years of age and older and the third leading cause of death among AI/AN individuals of all ages, and lung cancer is the leading cause of cancer death

Native, Sacred or Traditional Tobacco Use

For thousands of years, American Indian nations have believed that tobacco is a sacred gift with the power to both heal if used properly and cause harm if used improperly. Native tobacco is sacred and is used for ceremonial, spiritual and healing purposes. Although its use varies from tribe to tribe, common uses are as prayer, a gift or offering to show respect and medicine. Native tobacco is grown, gathered and prepared with care and respect and no chemicals are added. Unlike commercial tobacco, when used as indicated, it is not associated with addiction and adverse health effects. Ask an elder about how to use native tobacco.

Commercial Tobacco Use

Commercial tobacco, viewed as an abuse of sacred tobacco, is different from traditional, native tobacco. Commercial tobacco is intended for recreational, habitual use and is associated with significant short-term and long-term health effects. It is made with many added chemicals, mass produced in a non-respectful way and sold for profit.

Tobacco Industry Targeting

In their marketing campaigns, commercial tobacco companies have exploited the use of sacred tobacco among American Indians, misrepresenting their commercial products to increase sales to the Indian Nations.

Tobacco companies use a verity of marketing tactics to target American Indians, such as implying that the use of commercial tobacco and smokeless tobacco are elder-approved for ceremonial use, directly targeting minors, and offering lower priced products knowing Indian Nations are not held to local and state tobacco control laws that regulate other areas. Some companies have used American Indian imagery to promote the sale of commercial products and non-Native tobacco shops. In addition, the commercial companies provide sponsorship for community events, cultural events and directly to community organizations.

Effective Ways to Quit

Quitting is possible and you can do it! Quitting tobacco can not only benefit your health, but also the health of your loved ones and community. Involve your family and friends in your quitting plans so they are able to support you through the process.

There may be resources available in your community including local support groups. Call the QuitLine to create your individual quit plan and to stay quit for good all with ongoing support throughout your quit process.


Centers for Disease Control and Prevention. Vital Signs: Current Cigarette Smoking Among Adults Aged 18 Years - United States, 2009. Morbidity and Mortality Weekly Report 2010;59(35):1135 - 40 [accessed 2011 Aug 28].

Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report: Racial/ethnic differences among youth's cigarette smoking and susceptibility to start smoking - United States, 2002-2004, Vol. 55(47), December 1, 2006.

HHS, Tobacco Use Among U.S. Racial and Ethnic Minority Groups, Report of the Surgeon General, 1998,

CDC, "Cigarette Smoking Among Adults and Trends in Smoking Cessation - United States, 2008," MMWR 58(44), November 13, 2009,

American Cancer Society. Manipulating a Sacred Tradition: An Investigation of Commercial Tobacco Marketing & Sales Strategies on the Navajo Nation and other Native Tribes Report. Available at:

California Rural Indian Health Board, Tobacco Education & Prevention Technical Support Center (TEPTS). Countering the Misuse of American Indian Imagery. Available at: