Priority Populations/New Users Isaiah Brokenleg M.P.H. Behavioral Health Epidemiologist.

Priority Populations/New UsersIsaiah Brokenleg M.P.H.

Behavioral Health Epidemiologist

Prerequisites

• Acknowledge and pay respect to the Indigenous people whose land we use

• Indians are not all alike• Unique and different from other

Communities of Color• But similar due to shared experiences• Not “new users,” but “new abusers”

Traditional Tobacco

Traditional Tobacco (Nicotiana rustica)

• Given as gift to the people (various stories)

• Not to be bought or sold• By itself (asema) or Mixed (kinnickinick)

Commercial Tobacco

Commercial Tobacco (Nicotiana tobaccum)

• Not traditional to this area, imported• Addictive• Harmful when abused• Used as substitute• Hiding in plain sight

American Indian Tobacco Epidemiology

• According to BRFSS about 35.5% of American Indians (AI) in MN, WI & MI Smoke (n=126)

• The American Indian Community Tobacco Project found that 62% of AI adults in urban MN were smokers and only 12% had never smoked (n=300)

• 4 of the 5 leading causes of AI death in MN, WI, & MI are tobacco related

Relationships with Research

• Past harms have created mistrust of research

• Standard research methods do not work in “Indian Country”– Selection bias– Not differentiating between spiritual and

abusive tobacco use

• Research conducted does not benefit the Indian community

Relationships with Research

Wisconsin Native Youth

Tobacco Survey

What is the WNYTS?

• Culturally competent• Self-administered• School based • Tobacco survey

– Traditional/ceremonial use– Tobacco abuse– Thoughts/beliefs about tobacco– Environmental Tobacco Smoke exposure

Challenges

• Racial conflicts– Within/between communities– Off reservation schools– Perceptions of Indian capabilities

• Scheduling with schools and staff• Communication• $$ Thanks WI TPCP!!! (hugs and

kisses)

Successes

• First ever comprehensive statewide Native youth tobacco survey

• Used census method• Went about it in a “good way”• Large # of participants (N > 1800)• Built stronger relationships with

tribes, schools, and state• Demonstrated abilities of Indian work

Ceremonial Tobacco Use

Middle School Tobacco Abuse

High School Tobacco Abuse

Tobacco use = tobacco abuse?• Ceremonial users (at 1st glance) 40-

70% more likely to have abused or be current tobacco abusers

• Type of tobacco used in ceremony makes all the difference– Cigarettes for ceremony = 2 to 4 times

more likely to have abused or be current tobacco abusers

– Loose tobacco or traditional tobacco = 50-75% less likely to have abused or be be current tobacco abusers

Thanks!

Great Lakes Inter-Tribal Epidemiology CenterPO Box 9

Lac du Flambeau, WI 54548

715-588-3324

www.glitc.org/epicenter