Think tribally, act locally: Typology of approaches used for tribal tobacco policy work

American Indian communities suffer tremendously from the effects of commercial tobacco. With a smoking prevalence over 50%, the eleven Ojibwe and Dakota tribes in Minnesota face some of the highest disparities in tobacco-related health conditions. As sovereign nations, tribes are not subject to state smoke-free laws, so community members are forging their own path to creating healthy policies. ClearWay Minnesota, a nonprofit foundation created through the historic Minnesota tobacco settlement, assists tribes by funding the Tribal Tobacco Education and Policy (TTEP) projects. Beginning in 2008, ClearWay Minnesota provided funding for a full-time coordinator to work on tobacco policy change in four Ojibwe tribes. One of the tribes withdrew in 2009 and a Dakota tribe joined in 2011. Since 2009, our collaborative evaluation uses mixed methods, including monthly reviews and annual reflection sessions, to capture the advocacy process from the vantage point of tribes. We noted a pattern that TTEP coordinators are thinking tribally – integrating their teachings and knowledge of their own people and history -- then translating it locally to their specific setting and community. We have developed a basic typology to describe three approaches: networking, community organizing and community education. A combination of factors – tribal leadership, community readiness, and TTEP structure – along with each coordinator's specific interest and experience – led to an emphasis on different strategies in different communities. Respect (building capacity for “home-grown” strategies and sovereignty to flourish) and restoration (building on the strength of tradition) are integral to policy work in tribal communities.