Health | National

Smoking rates in Indian Country continue to top the nation

Youth from the Cheyenne River Sioux Tribe educate the community about the dangers of second-hand smoke. In May, the tribe became the first in South Dakota to ban smoking in public places. Photo from Canli Coalition / Facebook

Smoking rates among American Indians and Alaska Natives continue to outpace the rest of the nation, the Centers for Disease Control and Prevention reported.

Cigarette use is on the decline in the United States. According to the CDC, 16.8 percent of Americans reported using cigarettes on a regular basis last year, down from 20.9 percent in 2005.

"Cigarette smoking was significantly lower in 2014 (16.8%) than in 2013 (17.8%)," researchers wrote in the Morbidity and Mortality Weekly Report.

But Indian Country defies the trend. Some 29.2 percent of adult Native Americans reported current cigarette use in 2014, the highest of any racial or ethnic group, the CDC said.

Michael George Patterson, a Tlingit man from Alaska, started smoking when he was 9 years old. He now suffers from chronic obstructive pulmonary disease and speaks out against the dangers of tobacco use. Photo from Facebook

"Tobacco smoking is the leading cause of preventable disease and death in the United States, resulting in approximately 480,000 premature deaths and more than $300 billion in direct health care expenditures and productivity losses each year," researchers wrote.

There has been some change in Indian Country, though. Between 2005 and 2014, smoking rates among adult Native American men and women declined 8.6 percent, according to the CDC.

At the same time, greater percentage declines were seen among every other racial and ethnic group during the same period. Overall, smoking in the U.S. has fallen 19.8 percent in the last decade, researchers reported.

And in a remarkable shift, smoking rates among American Indian and Alaska Native women actually grew by 20.9 percent, the only group to show an increase, according to the CDC. The agency has previously reported high rates of smoking by pregnant women in Indian Country as far back as the 1990s

Nathan, a member of the Oglala Sioux Tribe, never smoked cigarettes but exposure to second-hand smoke for a prolonged period led to numerous health problems, according to the Centers for Disease Control and Prevention. He died in October 2013 at the age of 54.

On the other hand, cigarette usage declined among Native men by 31.7 percent -- one of the better improvement rates seen in the study.

The MMWR report does not offer a specific explanation for the high rates of smoking among Native Americans. Some studies have attempted to establish a link to the importance of tobacco in some tribal cultures but some researchers caution that such an approach can be one-sided.

"American Indians have been stereotyped in numerous unflattering ways, and these stereotypes have influenced not only the way the non-Indian community perceives American Indians, but how American Indians perceive themselves," Toni Watt of Texas State University, San Marcos, wrote in a 2014 study. "These stereotypes range from the patronizing portrayal of Indians as alcoholics to exaggerations of entrenched cultural commitments to alcohol and tobacco use."

According to the CDC, the tobacco industry -- which includes tribes that manufacture and distribute their own products -- has targeted Native Americans by funding powwows and rodeos and by designing packages with "Native" symbols and imagery.

Centers for Disease Control and Prevention Study:
Current Cigarette Smoking Among Adults — United States, 2005–2014 (Morbidity and Mortality Weekly Report November 13, 2015)

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