Online Program

Reservation youth commerical and ceremonial tobacco assesment: Use, perceptions, attitudes and beliefs

Tuesday, November 3, 2015

Helen Brown, RDN, MPH, Department of Movement Sciences, University of Idaho, Moscow, ID
Tara Kline, CPHQ, SSBB, CHP, Consultant, Spokane Valley, WA

Nationwide youth tobacco rates have declined but little is known about tobacco use, exposure, attitudes and perceptions among Reservation youth. State and national surveys do not assess sacred and ceremonial tobacco use and practices.  A tobacco survey that was both comparable to the CDC Youth Tobacco Survey and relatable to Reservation culture, customs and traditions was administered to  Native and non-Native youth grades 6th to 12th residing on a Northwest Reservation.


The Reservation Youth Tobacco Survey was modeled after the Great Lakes Inter-Tribal Youth Tobacco Survey. Adaptations were made to include Reservation specific graphics, customs and newer tobacco projects (snus, flavored cigars and electronic cigarettes).  Over 84% of enrolled students completed the survey (198); the majority of youth were Native American (64%).  All Reservation schools conducted the survey. Mostly descriptive data was analyzed using Microsoft Access, Excel, and Minitab 17 statistical software.


Consistent with national findings, 30 day Reservation youth use exceeded national rates (45% vs. 23%) and Native use was higher than non-Native (48% vs. 35%) for all tobacco products except chewing tobacco. Reservation Native youth had higher second hand tobacco exposure in homes, cars and work.  One in five Native youth used tobacco ceremoniously and less than half smoked it. Snus and electronic cigarette use was high, especially among females (39%). Perception of harm was low; only 41.2% reported electronic cigarettes were unsafe.  Most youth reported no tobacco harm messages from parents (60.6%), schools (60.8%) or media (41.7%).


Reservation youth, Native and non-Native are exposed to tobacco smoke and use and pro-tobacco messaging. The majority of youth lack protective messages from parents, schools and media and protective policies in homes, cars and worksites. Surveying Reservation youth is critical for strategic education, policy and environmental interventions in homes, schools and the Reservation community.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Public health or related laws, regulations, standards, or guidelines
Public health or related research

Learning Objectives:
Assess tobacco use among Native non-Native Reservation youth. Differentiate between tobacco use and harm attitudes between Reservation youth. Compare Reservation youth tobacco exposure by age and race.

Keyword(s): Tobacco Use, Native Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in tobacco control for 16 years and have assessed youth tobacco, alcohol and other drug use, attitudes and perceptions. I have over 15 years of experience working with Native Americans in public health and tobacco control programming.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.