Tobacco use among American Indians in Oklahoma: an epidemiologic view

OBJECTIVES: With the exception of national surveys that sample the entire U.S. population, little information exists on tobacco habits among American Indians. This study is a comparison of tobacco use findings in the 1990s among American Indians in Oklahoma, a state with a large and diverse American Indian population (39 tribes). METHODS: Data on current tobacco use are presented from two statewide surveys, the Oklahoma Youth Tobacco Survey and the Native American Behavioral Risk Factor Survey, as well as two large epidemiologic studies of chronic disease among American Indians-the Cherokee Diabetes Study and the Strong Heart Study. Three of these four sources of data involve research/surveys exclusively about American Indians. RESULTS: Nontraditional use of tobacco by American Indians occurs frequently, according to each instrument. Initiation to this habit begins in middle school and increases dramatically during high school. After age 50, reporting by individuals that they currently smoke declines steadily. CONCLUSIONS: Despite sampling different individuals for the surveys and different tribes for the epidemiologic research, results were comparable in age groups that overlapped. These findings support national data indicating that American Indians have higher prevalence rates of smoking than other racial/ethnic groups. American Indians report smoking on average about a half a pack of cigarettes per day. Individuals reporting using tobacco solely for ceremonial purposes were far fewer than habitual users. Buying tobacco products in American Indian smoke shops helps tribal economies; this fact needs to be considered for prevention programs to succeed.