For Specific Groups: 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. Overall, nearly 1 in 3 (31.8%) individuals with an American Indian/Alaska Native heritage smokes cigarettes.

*Source for cigarette smoking prevalence: Current Cigarette Smoking Among Adults—United States, 2016. Morbidity and Mortality Weekly Report, 2018.

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. Cigarette smoking is more common among American Indians/Alaska Natives than almost any other racial/ethnic group in the United States. Smoking increases the chances of:

  • Losing members of your tribe to smoking-related illnesses
  • Losing elders to smoking-related diseases or exposure to secondhand smoke before they can hand down tribal customs and traditions

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

  • Detailed Statistics Learn about smoking among specific populations and the current rates of cigarette smoking in the United States.

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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 smoking and exposure to secondhand smoke.

MichaelMeet Michael. Michael, age 57, lives in Alaska and began smoking at age 9. At 44, he was diagnosed with COPD — chronic obstructive pulmonary disease — which makes it harder and harder to breathe and can cause death.

NathanMeet Nathan. Nathan lived in Idaho. A member of the Oglala Sioux tribe, he was exposed to secondhand smoke at work that caused permanent lung damage and triggered asthma attacks so severe he had to leave his job. His illness led to his death on October 17, 2013. He was 54.

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

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Quitting Help

To get started right now, see our How to Quit Smoking area featuring a Quit Guide website and an additional Quitting Resources page.

You can call 1-800-QUIT-NOW (1-800-784-8669). Quitline coaches can answer questions, help you develop a quit plan, and provide support.

Additional resources that provide information about free counseling sessions, as well as help for tribes 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.

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Michael, an Alaska Native and member of the Tlingit tribe, started smoking at age 9. At 44, he was diagnosed with COPD—a condition that makes it harder and harder to breathe. Today, he struggles to play with his grandchildren or even carry a bag of groceries.

“Losing your breath is losing your life force.”