WASHINGTON – Cigarette use by Native Americans, already the highest in the nation, grew to 38.9 percent at a time when most other ethnic groups saw their rates dropping, according to a Centers for Disease Control and Prevention report released Thursday.
The report said smoking by Native American and Alaska Native adults grew from 37.1 percent in the period 2002 to 2005 to 38.9 percent between 2010 and 2013. That led other ethnic groups by a large margin, with blacks and whites tied for second-highest rate of cigarette smoking at 24.9 percent.
The numbers are “disappointing,” but not surprising, according to the director of the University of Arizona Center for Rural Health.
“We tend to see higher rates of tobacco use in rural populations and also certain minority populations,” such as Native Americans, said Dr. Daniel Derksen.
This was echoed by the associate director of the CDC Office of Smoking and Health, who noted the large differences in smoking between the ethnic groups.
“Even though the overall cigarette-smoking rate is declining, disparities remain among racial and ethnic groups and within subgroups,” Bridgette Garrett said in a statement released with the report.
“Looking beyond broad racial and ethnic population categories can help better focus the strategies that we know work to reduce tobacco use among sub-groups with higher rates of use,” she said.
Derksen said those strategies include cessation treatments in health insurance plans, policies that bar smoking indoors and in certain areas, and taxes on tobacco products. When all of these factors work together, Derksen said, cigarette smoking declines.
But many Native Americans in rural areas don’t have health insurance that includes treatments to quit smoking, and many live in areas with high rates of advertisements from tobacco companies seeking to develop “lifetime customers.”
“In the case of American Indians, you’re sometimes fighting all of those (factors),” Derksen said. “You might have a tax-free tobacco (store) in the neighborhood … You may have a casino close to the community where smoking is allowed in the community, so people are not only smoking but they’re able to buy cigarettes.”
After Native Americans, blacks and whites, Hispanics were next-highest with an adult smoking rate of 19.9 percent. Asians smoked the least from 2010 to 2013, according to the CDC, at 10.9 percent. Rates decreased for all groups except Native Americans and Alaska Natives, the CDC said.
There were wide disparities in smoking between ethnic groups and even within subgroups. While 10.9 percent of Asians overall smoked, rates within the group ranged from 7.6 percent for Chinese and Asian Indians to 20 percent for Koreans.
The CDC said cigarette smoking in the country had declined overall, but some of the strategies used to curb smoking weren’t working for certain groups.
“We know smoke-free policies, hard-hitting media campaigns, higher prices for tobacco products, and promotion of cessation treatment in clinical settings are proven to reduce tobacco product use,” said a statement from Corinne Graffunder, director of the CDC Office of Smoking and Health.
“If fully implemented and enforced, these strategies could help reduce tobacco use, particularly among racial and ethnic populations with higher rates of use,” her statement said.
Derksen noted that while many businesses have adopted smoke-free areas, Native American land often has casinos and hotels that allow smoking indoors – perpetuating cigarette culture and making it difficult for those who have quit to stay smoke-free. He added that smoking and drinking often go hand-in-hand.
“They are linked. There are certain populations that have had collateral damage from that,” Derksen said.
That “collateral damage” includes the most-recognized health consequence – lung cancer – but also includes an array of medical issues, including pulmonary and cardiovascular problems. And that’s not including the effect of secondhand smoke on those living with smokers, especially children, Derksen said.
And that can only change with multifaceted intervention strategies, he said.
“You can’t just focus on one intervention, you really have to approach it form these different levels to be effective,” Derksen said.