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Studies of two American Indian tribes reveal different rates of smoking but similarly high rates of life traumas

American Indians generally smoke more and suffer more life traumas than the rest of the U.S. population. Nevertheless, there remains substantial variation in smoking rates and trauma experience between tribal groups, according to two new studies. Both studies analyzed data from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protect Factors Project (AI-SUPERPFP). They were supported in part by the Agency for Healthcare Research and Quality (HS10854) and are briefly described here.

Henderson, P.N., Jacobsen, C., Beals, J., and the AI-SUPERPFP Team. (2005, May). "Correlates of cigarette smoking among selected Southwest and Northern Plains tribal groups: The AI-SUPERPFP study." American Journal of Public Health 95(5), pp. 867-872.

This cross-sectional study of Southwest and Northern Plains American Indians (ages 15 to 54 years) found that about half of Northern Plains men and women currently smoked (49 and 51 percent, respectively), while 19 percent of Southwest men and 10 percent of Southwest women smoked. The study did not determine use of tobacco for ceremonial purposes. However, the Northern Plains tribe bases a large part of their spiritual philosophy around the concept of the "sacred pipe," considerably more so than the Southwest tribe. Thus, the differences in smoking rates could have a significant cultural basis.

Men and younger people were more likely to smoke in the Southwest tribe, but not the Northern Plains tribe. This finding is consistent with other studies that suggest cigarette smoking among tribes of the Southwest region is on the rise, especially among younger men. People who were currently or formerly married and those who had spent less than 75 percent of their life on a reservation were more likely to smoke in the Northern Plains tribe.

Alcohol consumption was strongly associated with higher odds of smoking in both groups. The results underscore the need to consider each tribal group's unique characteristics when designing and implementing culturally sensitive smoking intervention programs in American Indian communities.

Manson, S.M., Beals, J., Klein, S.A., and others (2005, May). "Social epidemiology of trauma among 2 American Indian reservation populations." American Journal of Public Health 95(5), pp. 851-859.

Southwest and Northern Plains American Indians more often witness a traumatic event, suffer trauma to loved ones, and are the victims of physical attacks than the general U.S. population, concludes this study of trauma exposure among the two tribes. Researchers interviewed 3,084 members of the two tribes about their exposure to 16 types of trauma. They compared tribal prevalence rates of trauma with a sample of the U.S. general population in the National Comorbidity Survey (NCS).

Lifetime experience of any trauma was high across both tribes, ranging from 62.4 percent for male Southwest tribe members to 69.8 percent for female Northern Plains tribe members. This compares to lifetime exposure to any trauma among U.S. men and women at 60.7 percent and 51.2 percent, respectively. A third of the American Indians sampled reported that someone close to them had experienced a trauma. Female and male American Indians suffered equivalent levels of overall trauma exposures. Female tribal members were more likely than male tribal members to have suffered from interpersonal trauma, particularly physical abuse by a spouse.

The researchers suggest that high rates of trauma exposure may contribute to the increasing prevalence of cardiovascular disease among American Indian men and women, which is the leading cause of death in this group. Similarly, trauma is closely linked to pain, which negatively affects compliance with treatment, help-seeking behavior, and the speed of surgical recovery, all often compromised in American Indians.

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