BACKGROUND: American Indian/Alaska Natives (AI/ANs) are a distinct and unique population that experience a disproportionate burden of disease in the United States. AI/ANs traditionally use tobacco for a variety of spiritual and ceremonial purposes and recreational cigarette smoking is considered abuse. The AI/AN population in the Great Lakes region smoke at much higher rates and initiate smoking at younger ages than the all races population. However, many surveys conducted nationally such as Youth Risk Behavior Survey lack a sample size large enough to make any meaningful inferences about AI/AN populations. The Great Lakes Inter-Tribal Epidemiology Center (GLITEC) was contracted by the Wisconsin Tobacco Prevention and Control Program to conduct a state-wide Wisconsin Native Youth Tobacco Survey (WNYTS).
METHODS: The GLITEC created a culturally-appropriate self-administered survey based on a WNYTS GLITEC conducted in 2008. Tribal leaders, Tribal health directors, and Wisconsin schools were contacted to solicit support prior to implementation. Between January 2015 and December 2015, the WNYTS was conducted using an approximate census of 6-12 grade AI/AN students attending 28 different schools on and near Tribal reservations in Wisconsin (N=1,340).
RESULTS: Over half, 60% (n=1,328) of participants have tried cigarettes, but only 12% (n=1,331) currently smoke cigarettes. The majority, 73% (n=1,335) of participants have been taught how to use tobacco for ceremonial, prayer, or traditional reasons with 50% (n= 1,328) of participants responding that they live with someone who used tobacco for ceremonial, prayer or traditional purposes. Participants who reported using tobacco for traditional purposes were less likely to abuse commercial tobacco.
CONCLUSIONS: Nearly all commerical tobacco use begins during youth and young adulthood. Accurate, timely data play a critical role in informing interventions, creating policies, and allocating resources to not only to combat the burden of commercial tobacco use, but support the use of traditional tobacco. The WNYTS project is an example of how partnership between a state, Tribal Epidemiology Center, and Tribal communities can fill the surveillance data gap for tobacco use among AI/AN youth.