American Indian and Alaska Native People Experience a Health Burden from Commercial Tobacco

Commercial tobacco* prevents achieving health equity for American Indian and Alaska Native (AI/AN) people.

  • AI/AN people, compared to the other racial and ethnic groups, have a higher risk of death and disease caused by using commercial tobacco products like cigarettes, smokeless tobacco, and cigars.3,4,5
  • On average, AI/AN people are more likely to smoke cigarettes than other racial or ethnic groups in the United States (U.S.) Additionally, some AI/AN people are less likely to be covered by rules that reduce exposure to secondhand smoke.7,8,9,10
  • Cigarette smoking among AI/AN people varies across different parts of the country, with a lower prevalence in the Southwest and higher prevalence in Northern Plains and Alaska.11
  • Cardiovascular (heart and blood vessel) disease, which can be caused by cigarette smoking, is the leading cause of death among AI/AN people.12,13
  • Lung cancer, which can be caused by cigarette smoking and exposure to secondhand smoke, is the leading cause of cancer deaths among AI/AN people.5,12,13
  • Diabetes is the fourth leading cause of death among AI/AN people.12,13 The risk of developing type 2 diabetes is 30% to 40% higher for people who smoke than for people who don’t smoke, and smoking can worsen complications from diabetes.14
*“Commercial tobacco” means harmful products that are made and sold by tobacco companies. It does not include “traditional tobacco” used by Indigenous groups for religious or ceremonial purposes.
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