At a glance
- On average, AI/AN people are more likely to smoke cigarettes than other racial or ethnic groups in the U.S.
- AI/AN people, compared to the other racial and ethnic groups, have a higher risk of death and disease caused by using commercial tobacco products like cigarettes, smokeless tobacco, and cigars.
![Group of smiling teen girls](/tobacco-health-equity/media/images/2024/04/aian-girls-1200x675-1.jpg)
Commercial tobacco prevents achieving health equity for AI/AN people
- American Indian and Alaska Native (AI/AN) people, compared to the other racial and ethnic groups, have a higher risk of death and disease caused by using commercial tobacco products like cigarettes, smokeless tobacco, and cigars.A123
- On average, AI/AN people are more likely to smoke cigarettes than other racial or ethnic groups in the United States. Additionally, some AI/AN people are less likely to be covered by rules that reduce exposure to secondhand smoke.4567
- Cardiovascular (heart and blood vessel) disease, which can be caused by cigarette smoking, is the leading cause of death among AI/AN people.89
- Lung cancer, which can be caused by cigarette smoking and exposure to secondhand smoke, is the leading cause of cancer deaths among AI/AN people.389
- Diabetes is the fourth leading cause of death among AI/AN people.89 The risk of developing type 2 diabetes is 30% to 40% higher for people who smoke than for people who don't smoke, and smoking can worsen complications from diabetes.10
Content Source:
National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health
- "Commercial tobacco" means harmful products that are made and sold by tobacco companies. It does not include "traditional tobacco" used by Indigenous groups for religious or ceremonial purposes.
- Odani S, Armour BS, Graffunder CM, Garrett BE, Agaku IT. Prevalence and disparities in tobacco product use among American Indians/Alaska Natives — United States, 2010–2015. MMWR Morb Mortal Wkly Rep. 2017;66(50):1374–1378.
- Substance Abuse and Mental Health Services Administration. 2018 NSDUH Detailed Tables. Substance Abuse and Mental Health Services Administration; 2019. Accessed March 19, 2022. https://www.samhsa.gov/data/report/2018-nsduh-detailed-tables
- Espey DK, Jim MA, Cobb N, et al. Leading causes of death and all-cause mortality in American Indians and Alaska Natives. Am J Public Health. 2014;104(Suppl 3):S303–S311.
- U.S. Dept of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020. Accessed March 19, 2022. https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf
- O'Donald ER, Miller CP, O'Leary R, et al. Active smoking, secondhand smoke exposure and serum cotinine levels among Cheyenne River Sioux communities in context of a Tribal Public Health Policy. Tob Control. 2020;29(5):570–576.
- Public Health Law Center. Smoke-free Tribal Housing Policies. June 2020. Accessed March 19, 2022. https://www.publichealthlawcenter.org/sites/default/files/resources/Smoke-free-tribal-housing-policies.pdf
- Williams v Lee, 358 U.S. 217 (1958). Accessed March 19, 2022. https://www.loc.gov/item/usrep358217/
- Heron, M. Deaths: leading causes for 2017. Natl Vital Stat Rep. 2019;68(6):1–77. Accessed March 19, 2022.
- Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: final data for 2017. Natl Vital Stat Rep. 2019;68(9):1–77.
- U.S. Dept of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2014. Accessed March 19, 2022. https://www.ncbi.nlm.nih.gov/books/NBK179276/