According to the CDC, smoking among Native Americans is disproportionately high when compared to all other ethnicities in the United States. Among all Americans, smoking is the number one preventable cause of premature death. Statistical reports from a number of different public and private agencies confirm this. There are numerous socioeconomic reasons for the high number of Native American smokers. The most important among them is the cultural and religious role that tobacco (and other plants and herbs) play in Native American culture.
The following article will discuss the effects of smoking and its addictive properties, the relationship between Native Americans and marijuana, the effects of marijuana, efforts to reduce and prevent smoking among Native Americans and resources to help quit smoking.
For the purpose of this article, Native American collectively refers to both Native Americans and Alaska Natives.
Smoking Among Native Americans in Numbers
According to the CDC, more than one in five Americans with a Native American heritage smokes cigarettes. This is higher than any other ethnic group in the United States. Contributing factors toward this high rate of cigarette smoking among Native Americans include the religious, cultural, and medicinal roles that tobacco plays in their culture as well as the lack of taxes applied to cigarette sales on tribal lands. Lower tobacco prices have been demonstrated to result in higher incidence of tobacco use.
- In 2015, 21.9% of American Indian adults smoked cigarettes, compared to 15.1% of the overall U.S. population.
- In 2015, approximately one in five American Indian males smoked cigarettes (19%) and one in four American Indian females smoked cigarettes (24%).
- From 2005 to 2015, cigarette smoking prevalence decreased 31.6% among American Indian adults.
- According to the website, DodgingBullets.org, among American Indians between the ages of 12 and 17, there is a higher rate of cigarette use than the national average (16.8 percent versus 10.2 percent).
- By region, cigarette smoking is highest among Native Americans of the Northern Plains (44.1%) and in Alaska (39%), and is lowest in the Southwest (21.25). This correlates to the incidence of lung cancer in the Native American population. Lung cancer rates are highest in the Northern Plains and Alaska.
- The Indian Health Service spends $200 million per year on smoking-related illnesses.
- 20% of all Native American health care costs are due to tobacco-related illnesses.
Smoking exacts a great toll on Native American communities. Smoking increases the chances of losing family (as well as tribe) members to smoking-related illnesses. It also increases the possibility of cultural loss, due to losing tribe members before they can pass on the traditions and customs that were handed down to them.
Why is smoking so prevalent among Native Americans?
In Native American culture, tobacco and smoking play a large role. Tobacco is used for ritual purposes and is seen as a gift from the gods, as illustrated in the following popular legend:
From Ceremonial to Daily Use
The cultural roots of smoking are deep. Interestingly, the role of tobacco in Native American culture is purely ceremonial. While Native Americans use many different plants and herbs in their pipes, tobacco held a special place as an offering to the gods and was not intended for daily or casual use.
In addition to the cultural normality of smoking, the tobacco industry takes advantage of Native Americans (as well as other ethnicities). The industry exploits aspects of Native American culture to show smoking as a normal, natural activity. The industry also targets Native Americans by sponsoring cultural events such as rodeos and pow wows.
There is an economic link between Native Americans and cigarette smoking. According to the US Census Bureau, in 2015, 28.3% of Native Americans lived at or below the poverty level, compared to the national average of 15.5%. Poverty and smoking have a direct correlation. 26.1% of those living at or below the poverty level are smokers, compared to the national average of 13.9%.
Adverse Health Effects of Smoking
Smoking is the leading cause of preventable death in the United States, among all races and ethnicities. One out of every five deaths in the U.S. can be linked to tobacco use, resulting in 1,200 deaths per day. Tobacco use causes stroke, cancer, and heart disease. Exposure to tobacco during pregnancy can cause premature birth, low birth weight, and health problems for the baby. More than 480,000 deaths occur in the United States every year due to smoking and exposure to secondhand smoke.
Roughly 30% of all deaths due to cancer are directly related to smoking, and 87% of lung cancer deaths are directly related to smoking. In addition to lung cancer, smoking also increases the risk of esophageal, uterine, cervical and bladder cancer. Tobacco-related illness results in $75 billion per year in health care costs in the U.S.
Non-smokers may also be at risk for tobacco related illnesses. Secondhand smoke contains more than 4,000 toxic chemicals including ammonia, benzene, carbon monoxide and arsenic.
Secondhand smoke poses a real health threat. An hour in a smoke-filled room exposes a non-smoker to the toxins equivalent to having smoked one cigarette. Secondhand smoke is responsible for the deaths of 53,000 non-smokers each year in the United States – one out of every five lung cancer patients are non-smokers who were regularly exposed to secondhand smoke. In non-smokers, secondhand smoke is responsible for other types of cancer as well.
Secondhand smoke is also dangerous for babies and children. Secondhand smoke exposure increases the incidence of sudden infant death syndrome (SIDS), sinus and ear infections, dental issues, and asthma.
Why is Tobacco So Addictive
Cigarette companies develop their products to efficiently deliver nicotine to the smoker. Nicotine is a highly addictive drug, causing addiction in as little as 5 cigarettes. Nicotine is absorbed by the smoker’s bloodstream. Within seconds of entering the body, nicotine reaches the brain resulting in the sensation of pleasure. It also causes the brain to release adrenaline, giving the smoker a feeling of increased energy and well-being. These effects wear off rapidly, keeping smokers smoking to maintain that feeling.
Some of nicotine’s other effects include suppressed appetite, increased intestinal activity, elevated blood pressure, increased saliva production, and heightened alertness and memory.
Native Americans and Marijuana
In addition to tobacco, Native American culture has a long relationship with marijuana. Native American tribes all have their own customs and rituals, but most of them involve the smoking of pipes. Many different kinds of pipes exist, including peace pipes, ceremonial pipes, emblem pipes, and prayer pipes. The smoke that burning herbs and plants produces is seen as an offering to the gods. There are many different kinds of pipes (all seen as living entities), and many different kinds of plants and herbs that are smoked for different purposes.
As with tobacco use among Native Americans, marijuana use is also disproportionately high. According to a study by the National Institute on Drug Abuse, Native American children initiate alcohol and drug use earlier than the general population, and by the 10th grade, 36.2% of Native Americans have used marijuana in the last 30 days.
Effects of Marijuana
As with cigarette smoking, marijuana’s effects are quickly evident. Tetrahydrocannabinol (THC), marijuana’s main psychoactive component quickly enters the bloodstream and reaches the brain. Short-term effects of the chemical include:
- Dry mouth
- Short-term memory loss
- Impaired judgment
- Increased appetite
- Distorted perception
- Decrease in muscular coordination
Short term effects are better documented than long term effects, but long term effects may include:
- Loss of memory
- Negative effects on motor skills
- Difficulty focusing
Preventing Smoking Among Native Americans
From 2005 to 2015, smoking among Native American adults decreased 31.6%. Several factors are involved with this decrease.
- The National Tribal Tobacco Prevention Network encourages respect for the cultural uses of tobacco and the dangers of smoking. Their approach is grassroots, helping tribes to develop programs to educate their people and help with smoking cessation.
- Many native American-owned casinos are helping to prevent tobacco use and secondhand smoke exposure by making their facilities smoke free.
- Native Americans are being encouraged to stop smoking by engaging in healthy quitting behaviors.
Help with Quitting
Smoking cessation resources are abundant, online and off. Here are some good resources to help you begin your journey to a smoke free life:
www.smokefree.gov is a website with many tools to help you quit and to help those around you help you to quit. Under “Tools & Tips,” the site provides links to quitting apps, information, and the National Cancer Institute live chat as well as a toll free number that will connect you with your state’s quit smoking program (every state in the U.S. has one).
You can also visit the Center for Disease Control website, https://www.cdc.gov/tobacco/quit_smoking/index.htm for information on how to quit and the CDC quit smoking helpline (1-800-QUIT-NOW).
In addition to these online resources, your doctor or clinic can direct you to smoking cessation programs, as can your health insurer. Many health insurance programs as well as Medicaid and Medicare can help with the monetary cost of quitting smoking.