摘要：Objectives. We describe the prevalence and correlates of cigarette smoking in 2 American Indian tribal groups. Methods. We performed multinomial logistic regression on epidemiological data from a population-based, cross-sectional study of Southwest and Northern Plains American Indians aged 15 to 54 years. Results. We found that 19% of Southwest men, 10% of Southwest women, 49% of Northern Plains men, and 51% of Northern Plains women were current smokers. Male gender and younger age were associated with higher odds of smoking in the Southwest tribe, whereas current or former marriage and having spent less time on a reservation were associated with higher odds of smoking in the Northern Plains population. Alcohol consumption was strongly associated with higher odds of smoking in both groups. Conclusions. Cigarette smoking is a major public health concern among American Indians. Because correlates and smoking patterns vary among different tribal groups, each group’s unique characteristics should be considered when designing and implementing comprehensive, culturally appropriate interventions in American Indian communities. American Indians and Alaska Natives maintain high rates of commercial (as opposed to traditional) tobacco use, especially cigarette smoking, despite longstanding explicit health warnings about the addictive nature of nicotine and its association with cancer and cardiovascular diseases. 1, 2 American Indians overall have higher rates of current smoking compared to the general US population, 1, 2 especially those populations in the Northern Plains. 3– 6 Yet these high rates are not universal; smoking prevalence in Southwest tribes is often lower than in the general US population. 6, 7 The reasons for these differences are unclear, but given that smoking-related diseases are leading causes of death in these specific American Indian populations, 8 understanding tribal differences in the epidemiology of smoking is necessary to develop culturally appropriate prevention and treatment strategies. Several studies have described correlates of cigarette smoking in diverse ethnic populations. Among Asian Americans and Hispanics, acculturation variables such as use of the English language, language spoken at home, education level, and practice of ethnic traditions are strongly associated with increased tobacco use. 9– 12 Other studies have suggested lower income may be a key risk factor for smoking. 13 Very few studies, however, have examined correlates of smoking in American Indian or Alaska Native populations. 14, 15 In this analysis we describe the prevalence of current and former smoking in 2 American Indian reservation populations and examine the association of select sociodemographic variables with smoking status, using data from a population-based, cross-sectional study of American Indians aged 15 to 54 years. 16
