Native Americans & Point-of-Sale Commercial Tobacco

The tobacco industry has exploited Native American images, strategically and opportunistically taking advantage of a long history of some Native Tribes growing and using tobacco for their own sacred and medicinal purposes. The tobacco industry has used images representing Native cultures and bodies as a means of targeting Natives and other communities.^[2] The use of Native images on commercial tobacco products is a manipulation of a cultural history and practice for the sake of cigarette sales. It is common for cigarette brands to use stereotypical Native American images and motifs for branding and advertising, sometimes as a ploy to convince smokers that these cigarettes are more “natural” or health conscious. Research has found that Non-Hispanic American Indians and Alaska Natives are also more exposed to tobacco advertisements in stores than Non-Hispanic Whites.^[6]

As a result, 34.9% of adults who are Native American or Alaska Native (also known as First Nation or American Indian) reported current use of commercial tobacco in 2020 and have the highest prevalence of cigarette smoking among all racial/ethnic groups in the U.S.^[7] The leading cause of death for adults who are Native American are cardiovascular disease and lung cancer, both diseases proven to be related to the use of commercial tobacco products.^[1] There are dispa Advertisement for Cherokee brand cigarettes, which feature an image of a person in a traditional Native American headdress and the slogan "smoke the legend." rities around smoking in many other communities as well, but the smoking disparities for people who are Native American is one of the highest in the United States.

While commercial tobacco is readily available to people who are Native American on and off of reservations, and needs to be addressed, strategies to address tobacco sales and use within Native American communities must be culturally aware and respect the historical and cultural practices of the tribes. Tribes are already very aware of the health and community impacts of commercial tobacco and have created campaigns, such as “Keep It Sacred” as a means of refocusing Native American tobacco use back to cultural tradition rather than deadly commercial tobacco use.

Learn more about product packaging and the use of exoticism in tobacco advertising, and listen to a podcast on tobacco industry misappropriation of American Indian culture and traditional tobacco.

What is Traditional Tobacco?

Not all Native tribes have a cultural practice that involves the use of burning tobacco leaves, but in areas of the United States that have the warm and humid weather appropriate to growing tobacco, many have traditions of using traditional tobacco in spiritual ceremonies, gift giving, medicine, and teachings. Many tribes continue to pass down teachings and stories about the origins of traditional tobacco and its religious significance.

Tobacco used in tradition by people who are Native is usually grown, cropped, and prepared very specifically for its purpose. Some tribes have special containers that hold the prepared tobacco until it is ready to use. When tobacco is ceremonially burned, the smoke is generally held in the mouth and not inhaled into the lungs. Many tribes that burn tobacco believe that it carries their thoughts and prayers to their spiritual deities.³

Commercial tobacco is not grown or prepared with the same intentions as traditional tobacco. Commercial tobacco is grown, prepared, and sold in mass quantities and include thousands of extra chemicals and substances including menthol and ammonia that are not present in traditional tobacco used by people who are Native. For more information on traditional tobacco and its use check out Northwest Portland Area Indian Health Board’s report on Traditional Tobacco, and listed to this podcast on traditional vs. commercial tobacco from the National Native Network.

Reservations and Policy

While not all people who are Native American live on reservations, many do. Native reservations have treaties with the government giving them tribal sovereignty. Tribal Sovereignty allows tribes to control the laws and policies on the reservation without influence of the federal or state government. This means that the policy process may look different for each tribe, and it is important to engage and partner with tribal leaders to best understand the process for a particular reservation.

Because of tribal sovereignty, many of the federal policies that restrict forms of predatory marketing and selling of commercial tobacco may not impact reservations, which may also give tribes the opportunity to create their own policies without being impacted by preemption.

For more information on tribal sovereignty, see Partnerships with Native American’s article, What is Tribal Sovereignty?

Some federal policies, like the 2009 Family Smoking Prevention and Tobacco Control Act and the 2019 amendment raising the age of sale for commercial tobacco products to 21 apply to retailers located both on and off Tribal lands. See Federal Tobacco 21: Considerations for Tribal Communities from the American Indian Cancer Foundation, the Public Health Law Center, and the Minnesota Department of Health for more information.

Policy Strategy

It is important to recognize the great diversity that exists between tribes. With at least 567 federally recognized tribes across the U.S, interventions to reduce commercial tobacco use will vary in strategy and approach, with the most successful likely being culturally specific and community-based. As described in the report “In a Good Way: Indigenous Commercial Tobacco Control Practices” compiled by ClearWay Minnesota, Truth Initiative, and Blue Cross and Blue Shield of Minnesota, what the tobacco control field thinks of as “evidence-based” practices may not be inclusive of or apply as readily to Native communities. The report, which highlights tribally-based strategies developed through the CDC’s formerly funded Tribal Support Centers and ClearWay Minnesota’s Tribal Tobacco Education and Policy grant initiatives, states, “…What works in one community may not find success in another. The most successful approaches may come from far outside the traditional public health approach to the problem: youth leadership training, community gardens, or traditional language classes. There’s no one size fits all approach here, no single standardized tool kit that produces reliably measurable results. Native tradition and knowledge creates this valuable practice-based evidence, techniques and practices designed by these communities themselves to address a disparity where mainstream public health has failed to deliver results…” It is also important to recognize that the word “policy” may also be perceived negatively in some Native communities given that federal policies have that caused so much historical trauma and harm to them.

Native tribes are working towards decreasing the influence of commercial tobacco in a variety of way, including by emphasizing the cultural and historical significance of traditional tobacco and by creating policies around commercial tobacco. For example, Tribes in Minnesota are working on tobacco control policies to create smoke free spaces and pow wows, offering cessation help in clinics, and offering monthly classes on how to grow and harvest traditional tobacco. Learn more about the strategies used by Minnesota tribes here.

Several Tribes have taken action to restrict the sale of e-cigarettes, both in response to the outbreak of lung injuries associated with use of the products (EVALI) and in response to companies like JUUL pushing their products on the reservations. While some bans were temporary, others chose to enact permanent bans. For example:

In September 2019, the Oglala Sioux Tribe permanently banned all e-cigarettes on the Pine Ridge Reservation.
In October 2019, the Turtle Mountain Band of Chippewa Tribe banned the sale of all vaping products on Tribal land, and the Lac Courte Oreillles Tribe banned the sale of all vaping products in all tribal retail outlets.
In November 2019, the Muckleshoot Tribe banned the sale of flavored vaping products and raised the minimum legal sales age for all tobacco products to 21.
In December 2019, the Saint Regis Mohawk Tribe banned the sale and distribution of all flavored vaping products and raised the minimum age for vaping products to 21.

Also see the Public Health Law Center’s Addressing Tobacco Industry Targeting of of Tribes for a model resolution on electronic smoking devices and commercial tobacco industry sponsorships that Tribes can adopt.

Native community members can advocate to decrease the influence of the commercial tobacco industry on reservations and the Native community at large using point-of-sale policies such as price increases, minimum pack sizes, limiting retailers in close proximity to schools through licensing and zoning, and restricting flavored and menthol products.

There is substantial variation in commercial tobacco retailing across Tribal jurisdictions. One study comparing practices on and near Tribal jurisdictions in Arizona, California, and Oklahoma between 2015 – 2017 found that while e-cigarettes were ubiquitous, there was a more variation in conventional cigarette availability, with the most types of cigarettes and more advertisements for cigarettes present at tobacco specialty shops in Tribal Oklahoma.^[6] Prices varied as well, with some Tribal commercial tobacco retailers selling products at higher prices than non-Tribal competitors, while others had lower prices.^[6]

However, policies in areas surrounding Tribal lands may also impact use. Stores located within a 1-mile radius of Tribal lands in California were more likely to sell e-cigarettes, offer price promotions for cigarettes, sold significantly more flavored and total little cigars and cigarillos, displayed more of these items for less than $1, and were more likely to advertise price promotions on these products than stores located on Tribal lands. ^{[4, 5 ]}

Resources

Learn more about traditional Native American use of tobacco:

National Native Network – Keep It Sacred
National Tribal Prevention Network – Traditional Tobacco Fact Sheets
Article – Award-Winning Documentary looks at Native Americans’ Complex Relationship with Tobacco
Best Practices User Guide – Tobacco Where You Live: Native Communities