American Indian

The Story of American Indian

Some American Indian traditional use of tobacco is for ceremonial or religious reasons, which creates an important distinction between traditional and commercial use. The tobacco industry preys on these traditions, funding powwows and promoting brands like Natural American Spirit1. They appropriate American Indian cultures to sell their deadly products, not to show meaningful support for American Indian communities2.

Big Tobacco also sees American Indian-owned casinos as an avenue to distribute their products.  The Industry funds these businesses in exchange for carrying an endless supply of cigarettes, preying on concerns that allowing indoor smoking is key to their casino’s success,3 despite evidence that a smoke-free environment would actually increase patronage.4

This kind of cultural exploitation contributes to American Indian communities having the highest rate of smoking prevalence in California, and the only group where smoking is on the rise.5 Nearly one in three native adults in California smoke.  However, tobacco’s harm goes beyond those that use it – native populations also report more exposure to secondhand smoke at home.6

It’s time to break Big Tobacco’s grip on American Indian communities.

  1. https://truthinitiative.org/news/tobacco-social-justice-issue-racial-and-ethnic-minorities
  2. Joanne D’Silva, Erin O’Gara, Nicole T Villaluz, Tobacco Industy Misappropriation of American Indian Culture and Traditional Tobacco
  3. Manipulating a Sacred Tradition: An Investigation of Commercial Tobacco Marketing & Sales Strategies on the Navajo Nation and other Native Tribes, American Cancer Society and Americans for Nonsmokers Rights.
  4. Isaiah “Shaneequa” Brokenleg, MPH, Teresa K. Barber, MEd, Nancy L. Bennett, BS, Simone Peart Boyce, PhD, and Valarie Blue Bird Jernigan, DrPH, Gambling with Our Health: Smoke-Free Policy Would Not Reduce Tribal Casino Patronage, U.S. National Library of Medicine, National Institutes of Health, ; David S Timberlake, corresponding author, Jun Wu, and Wael K Al-Delaimy, Tribal casinos in California: the last vestige of indoor smoking, U.S. National Library of Medicine, National Institutes of Health,
  5. 2017 Story of Inequity, Indicator: Prevalence of adult cigarette smoking by priority population group and Indicator: Rate of change in prevalence of adult cigarette smoking by priority population group, 2007 to 2013-2014.
  6. 2017 Story of Inequity, Proportion of each priority population group with a smoke-free home.

The Proof is in the Data

[ Data last updated March 2023 ]

Indicator
American Indian
General Population
Adult Tobacco Use
1.Adult Cigarette Use: Adult cigarette smoking prevalence8.9%6.7%
  • California Health Interview Survey, 2019-20. Los Angeles, CA: UCLA Center for Health Policy Research.
2.Change in Adult Cigarette Use: Rate of change in adult cigarette smoking, 2014 to 2020The 2020 estimate is significantly lower than the 2014 estimate.-72.3%-46.4%
  • California Health Interview Survey, 2019-20. Los Angeles, CA: UCLA Center for Health Policy Research.
  • California Health Interview Survey, 2013-14. Los Angeles, CA: UCLA Center for Health Policy Research.
3.Adult Tobacco Use: Adult tobacco use prevalence (e.g. cigarettes, e-cigarettes and other vaping products, other tobacco products)18.9%11.3%
  • California Health Interview Survey, 2019-20. Los Angeles, CA: UCLA Center for Health Policy Research.
Youth Tobacco Use
4.Youth Cigarette Use: Youth cigarette smoking prevalence2.4%1.2%
  • California Student Tobacco Survey, 2019-20. San Diego, CA: Center for Research and Intervention in Tobacco Control, University of California, San Diego.
5.Change in Youth Cigarette Use: Rate of change in youth cigarette smoking, 2016 to 2020-57.9%-72.1%
  • California Student Tobacco Survey, 2019-20. San Diego, CA: Center for Research and Intervention in Tobacco Control, University of California, San Diego.
  • California Student Tobacco Survey, 2015-16. San Diego, CA: Center for Research and Intervention in Tobacco Control, University of California, San Diego.
6.Youth Tobacco Use: Youth tobacco use prevalence (e.g. cigarettes, e-cigarettes and other vaping products, other tobacco products)The estimate is significantly higher than the California general population.13.9%9.7%
  • California Student Tobacco Survey, 2019-20. San Diego, CA: Center for Research and Intervention in Tobacco Control, University of California, San Diego.
Availability of Tobacco & Tobacco Industry Influence
7.Cheapest Cigarettes: Average price for the cheapest pack of cigarettes$7.02$7.11
  • Healthy Stores for a Healthy Community, 2019. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2014-2018. Suitland, MD: U.S. Census Bureau.
8.Flavored Little Cigar Price: Average price for a single flavored little cigar/cigarillo$0.98$0.97
  • Healthy Stores for a Healthy Community, 2016. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2011-2015. Suitland, MD: U.S. Census Bureau.
9.Tobacco Retail Licensing: Proportion of population protected by a strong tobacco retail licensing law49.8%59.5%
  • Policy Evaluation Tracking System, April 2021. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2015-2019. Suitland, MD: U.S. Census Bureau.
  • Decennial Census, 2010. Suitland, MD: U.S. Census Bureau.
10.Tobacco Stores: Density of stores selling tobacco per 100,000 residentsThe estimate is 10.0 stores per 100,000 higher than the California general population.98.477
  • California Cigarette and Tobacco Products Retailer Licensees, November 2021. Sacramento, CA: California Department of Tax and Fee Administration.
  • American Community Survey, 2014-2018. Suitland, MD: U.S. Census Bureau.
  • Decennial Census, 2010. Suitland, MD: U.S. Census Bureau.
11.Flavored Tobacco: Proportion of stores that sell flavored non-cigarette tobacco productsThe estimate is significantly higher than the California general population.86.5%81.8%
  • Healthy Stores for a Healthy Community, 2019. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2014-2018. Suitland, MD: U.S. Census Bureau.
12.Menthol Cigarettes: Proportion of stores that sell menthol cigarettes90.9%88.3%
  • Healthy Stores for a Healthy Community, 2019. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2014-2018. Suitland, MD: U.S. Census Bureau.
13.Tobacco Advertising: Proportion of stores that keep 90% of their storefront free from any advertising39.4%40.1%
  • Healthy Stores for a Healthy Community, 2019. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2014-2018. Suitland, MD: U.S. Census Bureau.
Secondhand Smoke
14.Adult Secondhand Tobacco Exposure: Proportion of adults exposed to secondhand smoke or vapeThe estimate is significantly higher than the California general population.54.8%35.2%
  • California Health Interview Survey, 2019-20. Los Angeles, CA: UCLA Center for Health Policy Research.
15.Youth Secondhand Tobacco Exposure: Proportion of youth exposed to secondhand smoke or vape33.8%33.1%
  • California Student Tobacco Survey, 2019-20. San Diego, CA: Center for Research and Intervention in Tobacco Control, University of California, San Diego.
16.Smoke-free Multi-unit Housing: Proportion of population protected by a smoke-free multi-unit housing law60%66.7%
  • Policy Evaluation Tracking System, April 2021. Sacramento, CA: California Department of Public Health, California Tobacco Control Program.
  • American Community Survey, 2015-2019. Suitland, MD: U.S. Census Bureau.
  • Decennial Census, 2010. Suitland, MD: U.S. Census Bureau.
17.Smoke-free Homes: Proportion of adults with smoke-free homes82.4%91.8%
  • California Health Interview Survey, 2019-20. Los Angeles, CA: UCLA Center for Health Policy Research.
Cessation
Kick It California
Percent of Enrollees
Percent of Smokers
18.Kick It California Enrollees: Proportion of Kick It California enrollees1.3%0.5%of smokers are
American Indian
  • California Smokers' Helpline Caller Intake Reports, 2020. San Diego, CA: California Smokers’ Helpline, University of California, San Diego.
  • California Health Interview Survey, 2019-20. Los Angeles, CA: UCLA Center for Health Policy Research.

Organizations around the state are working
to fix tobacco-related health disparities.

Find out more about what each organization is doing to fight the
tobacco industry's predatory tactics.

How you can help

You have a voice and can make a difference.

Fix It!

A Story of Inequity

Tobacco’s Impact on Health Disparities in California

For decades, the tobacco industry has aggressively targeted California’s diverse communities with predatory practices. Internal documents from Big Tobacco outline their strategies – many of which are shocking attempts to peddle deadly products by way of product discounts and manipulative advertising. They even gave away free products to youth in the past. These tactics masquerade as support for communities under the guise of cultural celebration.

Unfortunately, the tactics have worked. Big Tobacco aggressively targeted communities and, as a result, some populations have higher rates of tobacco use, experience greater secondhand smoke exposure at work and at home, and have higher rates of tobacco-related disease than the general population.1

Addressing tobacco-related health inequities is key to California’s efforts to fight tobacco, our state’s number one cause of preventable death and disease.2 Tobacco use, pricing, and its impact across California were analyzed where significant disparities were found across various populations. See how Big Tobacco affects each community in the Nation’s most diverse state.

A Story Of Inequity Methodology >

  1. Centers for Disease Control and Prevention and Tobacco-Related Disparities
  2. Extinguishing the Tobacco Epidemic in California, April 11, 2017, Centers for Disease Control and Prevention

A Story of Inequity

Tobacco’s Impact on Health Disparities in California

For decades, the tobacco industry has aggressively targeted California’s diverse communities with predatory practices. Internal documents from Big Tobacco outline their strategies – many of which are shocking attempts to peddle deadly products by way of product discounts and manipulative advertising. They even gave away free products to youth in the past. These tactics masquerade as support for communities under the guise of cultural celebration.

Unfortunately, the tactics have worked. Big Tobacco aggressively targeted communities and, as a result, some populations have higher rates of tobacco use, experience greater secondhand smoke exposure at work and at home, and have higher rates of tobacco-related disease than the general population.1

Addressing tobacco-related health inequities is key to California’s efforts to fight tobacco, our state’s number one cause of preventable death and disease.2 Tobacco use, pricing, and its impact across California were analyzed where significant disparities were found across various populations. See how Big Tobacco affects each community in the Nation’s most diverse state.

A Story Of Inequity Methodology >

  1. Centers for Disease Control and Prevention and Tobacco-Related Disparities
  2. Extinguishing the Tobacco Epidemic in California, April 11, 2017, Centers for Disease Control and Prevention