Among racial and ethnic groups, the prevalence of smoking is highest among
American Indians/Alaska Natives (40.8 percent), intermediate among
non-Hispanic whites (23.6 percent) and non-Hispanic blacks (22.4 percent)
and lowest among Hispanics (16.7 percent) and Asians/Pacific Islanders
Smoking rates among American Indians and Alaska Natives vary greatly by
region. Smoking rates are highest among Alaskan Natives (45.1 percent) and
the Northern Plains tribes (44.2 percent) and lowest among southwest tribes
(17.0 percent). The prevalence of heavy smoking (more than 25 cigarettes
per day) is also highest in the Northern Plains (13.5 percent).
American Indian and Alaska Native lands are sovereign nations and are not
subject to state laws prohibiting the sale and promotion of tobacco
products to minors. As a result, American Indian and Alaska Native youth
have access to tobacco products at a young age. Tobacco is also considered
a sacred gift and it is used during religious ceremonies and as traditional
Chronic cigarette smoking and spit tobacco use increases the risk of
developing tobacco-related health problems. Tobacco use is a risk factor
for heart disease, cancer, and stroke – all leading causes of death among
American Indians and Alaska Natives.
Although American Indians have the highest rates of current smoking, they
are less likely to be heavy smokers. The percentage of American Indian and
Alaska Native smokers who reported that they were light smokers (smoking
fewer than 15 cigarettes per day) was 60.9 percent compared to 43.8 percent
In 2002, American Indian and Alaska Native women had the highest rate of
smoking during pregnancy (19.9 percent) compared to non-Hispanic white
(15.5 percent) and non-Hispanic black (9.1 percent) women.
American Indian and Alaska Native youths also have the highest rates of
smoking compared to other racial/ethnic groups. In 2001, 29 percent of
American Indian and Alaska Native youths aged 12 – 17 smoked compared to
13.4 percent of whites.
In 2002, only 32.1 percent of American Indian/Alaska Native smokers tried
to quit for at least one day compared to 43.5 percent of white smokers.
As smoking declines among the white non-Hispanic population, tobacco
companies have targeted American Indian/Alaska Natives by funding cultural
events such as pow wows and rodeos to build its image and credibility in