American Indians / Alaska Natives

Know the Facts

Cigarette smoking is more common among American Indians/Alaska Natives than almost any other racial/ethnic group in the United States.*

  • More than 1 in 5 (20.9% ) American Indian/Alaska Native adults smokes cigarettes.*

Smoking increases the chances of:

  • Losing members from your tribal community to smoking-related illnesses
  • Losing elders to smoking-related diseases or exposure to secondhand smoke before they can pass down tribal customs and traditions

If you are an American Indian or Alaska Native, you likely know someone with health problems from cigarette smoking—possibly a member of your family with a smoker’s cough who is struggling to breathe or a friend with lung cancer.

Smoking cigarettes while you are pregnant increases the risk for pregnancy complications. These health problems may be a special risk in AI/AN communities, where smoking during pregnancy is more common than among other ethnic groups.

If you smoke during pregnancy, you may give birth to a premature baby or a baby who weighs less than 5½ pounds. Sudden infant death syndrome (known as SIDS or crib death) is another danger for babies of moms who smoke during pregnancy.

Babies and children who are exposed to tobacco smoke can continue to have health problems. These health problems can include bronchitis, pneumonia, and ear infections. You can help protect future generations by keeping children away from cigarette smoke.

For More Information

Real Stories: American Indians / Alaskan Natives Featured in Tips®

Learn the real stories of American Indians / Alaskan Natives who are suffering from illness or health conditions as a result of cigarette smoking and exposure to secondhand smoke.

Learn more about all Tips participants in our Real Stories section.

Free Quitting Resources


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Nathan M., a Native American and veteran of the U.S. military, never smoked cigarettes. But years of working in a casino that allowed smoking damaged his lungs and led to his death in 2013 at age 54.

“I want to make people aware of the damage that exposure to secondhand smoke can do to you.”

Today I start my quit journey. Free resources provided by

Quitting Help

To get started right now, see our How to Quit Smoking area featuring a Quit Guide.

Get free help to quit smoking by calling a quitline: 1-800-QUIT-NOW (1-800-784-8669). Quitline coaches can answer questions, help you develop a quit plan, and provide support.

Additional information for tribes about free counseling sessions, as well as quitting resources, include:


Quit-smoking treatments may be free or reduced in price through insurance, health plans, or clinics.

State Medicaid programs cover quit-smoking treatments. While the coverage varies by state, all states cover some treatments for at least some Medicaid enrollees.

Medicare currently covers two quit attempts per year and up to four face-to-face counseling sessions per attempt.

*Tobacco Product Use Among Adults – United States, 2019. Morbidity and Mortality Weekly Report 2020.