Priority Populations/New Users
Isaiah Brokenleg M.P.H.
Behavioral Health Epidemiologist
Prerequisites
• Acknowledge and pay respect to the
Indigenous people whose land we use
• Indians are not all alike
• Unique and different from other
Communities of Color
• But similar due to shared experiences
• Not “new users,” but “new abusers”
Traditional Tobacco
Spiritual
Commodity
Physical
Purposes
Medicine
Communicates
Prayer
Traditional Tobacco
(Nicotiana rustica)
• Given as gift to the people (various
stories)
• Not to be bought or sold
• By itself (asema) or Mixed (kinnickinick)
Commercial Tobacco
2nd Best
Money
Maker
Imagery
Addiction
Commercial Tobacco
(Nicotiana tobaccum)
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Not traditional to this area, imported
Addictive
Harmful when abused
Used as substitute
Hiding in plain sight
American Indian Tobacco Epidemiology
• According to BRFSS about 35.5% of
American Indians (AI) in MN, WI & MI
Smoke (n=126)
• The American Indian Community
Tobacco Project found that 62% of AI
adults in urban MN were smokers and
only 12% had never smoked (n=300)
• 4 of the 5 leading causes of AI death in
MN, WI, & MI are tobacco related
Relationships with Research
• Past harms have created mistrust of
research
• Standard research methods do not
work in “Indian Country”
– Selection bias
– Not differentiating between spiritual and
abusive tobacco use
• Research conducted does not benefit
the Indian community
Relationships with Research
Previous
Harm/Trust Issues
Need for
Data
C.B.P.R.
Research
Problems
Wisconsin Native
Youth Tobacco
Survey
What is the WNYTS?
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•
•
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Culturally competent
Self-administered
School based
Tobacco survey
– Traditional/ceremonial use
– Tobacco abuse
– Thoughts/beliefs about tobacco
– Environmental Tobacco Smoke exposure
Challenges
• Racial conflicts
– Within/between communities
– Off reservation schools
– Perceptions of Indian capabilities
• Scheduling with schools and staff
• Communication
• $$ Thanks WI TPCP!!! (hugs and
kisses)
Successes
• First ever comprehensive statewide
Native youth tobacco survey
• Used census method
• Went about it in a “good way”
• Large # of participants (N > 1800)
• Built stronger relationships with
tribes, schools, and state
• Demonstrated abilities of Indian work
Ceremonial Tobacco Use
Middle School Tobacco Abuse
High School Tobacco Abuse
Tobacco use = tobacco abuse?
• Ceremonial users (at 1st glance) 4070% more likely to have abused or be
current tobacco abusers
• Type of tobacco used in ceremony
makes all the difference
– Cigarettes for ceremony = 2 to 4 times
more likely to have abused or be current
tobacco abusers
– Loose tobacco or traditional tobacco =
50-75% less likely to have abused or be
be current tobacco abusers
Thanks!
Great Lakes Inter-Tribal Epidemiology Center
PO Box 9
Lac du Flambeau, WI 54548
715-588-3324
www.glitc.org/epicenter