‘This Tobacco Has Always Been Here for Us,’ American Indian Views of Smoking: Risk and Protective Factors

We utilized eight talking circles to elicit American Indian views of smoking on a U.S. reservation. We report on (1) the historical context of tobacco use among Ojibwe Indians; (2) risk factors that facilitate use: peer/parental smoking, acceptability/availability of cigarettes; (3) cessation efforts/ inhibiting factors for cessation: smoking while pregnant, smoking to reduce stress , beliefs that cessation leads to debilitating withdrawals; and (4) protective factors that inhibit smoking initiation/use: negative health effects of smoking, parental and familial smoking behaviors, encouragement from youth to quit smoking, positive health benefits, “cold turkey” quitting, prohibition of smoking in tribal buildings/homes. Smoking is prevalent, but protective behaviors are evident and can assist in designing culturally sensitive prevention, intervention and cessation programs