Stressful Life Events, Ethnic Identity, Historical Trauma, and Participation in Cultural Activities: Associations with Smoking Behaviors among American Indian Adolescents in California

Introduction: American Indian (AI) adolescents have the highest prevalence of commercial tobacco use of any ethnic group in the United States.  This study examines ethnic identity, participation in cultural activities, and stressful life events as correlates of smoking and examines historical trauma as a mediator of these associations.

Methods: California AI youth (N= 969, ages 13-19, recruited from 49 tribal youth organizations and cultural activities in urban and reservation areas in California) completed a culturally-specific tobacco survey.  Structural equation modeling was used to test a model examining historical trauma as a potential mediator of the effects of ethnic identity, participation in cultural activities, and stressful life events on smoking behaviors among California AI adolescents. 

Results:  Ethnic identity, participation in cultural activities, and stressful life events predicted historical trauma.  Historical trauma mediated the associations of participation in cultural activities and stressful life events with past-month smoking.  Stronger ethnic identity predicted greater past-month smoking and this effect was mediated by greater historical trauma.  The direct effects from historical trauma to both smoking outcomes were positive; and the direct effect from ethnic identity to past-month smoking was negative.

Conclusions:  AI youth have a conceptual understanding of the detrimental impact of historical trauma events on AI populations and have learned about them interpersonally or through experiences that trigger thoughts of historical loss.  More efforts are needed to help AI youth to process these thoughts and empower themselves to contribute to their own lives and those of their families and communities without resorting to unhealthy addictive behaviors such as commercial tobacco use.