Behind the Smokescreen: Addressing Native American Tobacco Use in Oklahoma

Do Native Americans in Oklahoma hold significantly different attitudes toward the health dangers of tobacco than non-Natives? Across 38 tribes, Oklahoma Native Americans comprise the second highest Native American state population, and 12.4 percent of the total U.S. Native American population. Oklahoma agencies have developed an anti-tobacco health education campaign focusing on ceremonial tobacco use while also encouraging tribal members to quit tobacco. Using data from the Adult Tobacco Survey (2004-2008), we tested differences between Native Americans and non-Native Americans regarding tobacco-related disease including secondhand smoke, harm to a fetus by a smoking mother, and risk of addiction. Because Native American females are the only group failing to decrease smoking rates since 1978, we also analyzed women separately. Results based on Ordinary Least Squares (OLS) and binary logistic regression analyses reveal that Native Americans did not differ significantly from non-Native Americans in agreement with statements that smoking cigarettes or being exposed to secondhand smoke contribute to major diseases. However, Native Americans are less likely than non-Native Americans to believe that cigarettes are addictive, smoking is harmful to a fetus, and secondhand smoke is harmful. These findings have policy implications for the future design of Oklahoma anti-tobacco campaigns targeted to Native Americans. Where current campaigns focus on the historical relationship tobacco has with Native American culture and ceremonies, more attention should be devoted to issues of cigarette addiction including tobacco industry targeting of non-smokers, smoking while pregnant, and general harm of breathing secondhand smoke.