American Indian Adolescent Secondhand Smoke Exposure

Introduction: Cigarette smoking among American Indian adolescents is higher than other populations, and limited data indicate that this is especially pronounced in the Upper Midwest where adult smoking rates are extremely high (42 – 62%). Little is known about American Indian secondhand smoke (SHS) exposure. We examined SHS exposure among American Indian adolescents in Minneapolis and St. Paul, along with other social and environmental factors associated with adolescent cigarette smoking. Methods: Cross-sectional sample of 336 American Indians age 11 to 18 were given a self-administered survey. Data were analyzed using bivariate chi-square tests and multivariate logistical stepwise regression. Results: Almost 37% of the adolescents smoked cigarettes in the previous 30 days. Social exposure to cigarette smoking and SHS was very strong; 78% live with at least one adult smoker, 59% have a friend who smokes and 44% have a sibling who smokes. More than 75% reported being in a room where someone was smoking in the previous week. Yet more than 65% report a household rule against them smoking, and 43% report a rule against any smoking in the home. Nonsmokers were most likely to report household rules against them smoking, and living in a household with a smoking ban. SHS exposure was also strongly associated with smoking frequency. Conclusion: These results indicate that American Indians in this area have not benefited from tobacco control and prevention strategies. Future efforts should stress the importance of promoting smoke-free homes as a youth prevention strategy.