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Culture and Tobacco Among American Indian Adolescents

Institution: University of Southern California
Investigator(s): Jennifer Unger, Ph.D. Lourdes Baezconde-Garbanati, Ph.D., M.P.H.
Award Cycle: 2006 (Cycle 15) Grant #: 15RT-0111 Award: $824,825
Subject Area: Epidemiology
Award Type: Research Project Awards

Initial Award Abstract
California. Research is needed to understand the risk and protective factors for tobacco use among AI adolescents. When creating tobacco prevention messages for AI adolescents, it is important to be cognizant of the sacred role of tobacco in many traditional AI cultures. Tribes throughout California vary widely in their use of tobacco. Many tribes consider tobacco a healing herb and use it in ceremonies to facilitate communication with the spirits, show respect for the dead, and cure numerous ailments. Traditional tobacco use is reserved for special occasions, and the tobacco is often used in other ways besides burning and inhaling. Modern-day recreational, habitual use of commercial tobacco is much different from the traditional use of sacred tobacco; it is an addictive behavior with serious health consequences.

In most AI cultures, there is a distinction between traditional use of sacred tobacco and recreational use of commercial tobacco. However, in our modern-day world, the distinction can sometimes become blurred, because some tribes use commercial tobacco when homegrown tobacco is not available, and tobacco companies have used AI imagery to advertise commercial tobacco brands. This blurring of the line between sacred and commercial tobacco may be confusing to adolescents, who may come to believe that smoking commercial tobacco is culturally acceptable and not harmful.

This study will conduct surveys of 1000 AI adolescents in California to identify the general and culturally specific risk and protective factors for their tobacco use. This will set the stage for the development of more effective and culturally relevant health education messages to prevent recreational use of commercial tobacco among AI adolescents in California.

This study will 1. Create a survey of tobacco-related risk and protective factors that are salient to AI adolescents, using findings from previous research and input from our community advisory committee. 2. Pilot test the survey in a sample of 100 AI adolescents, and revise the survey as necessary to improve the psychometrics of the scales. 3. Administer the revised survey to a sample of 1000 AI adolescents attending 20-30 schools throughout urban and rural areas of California. 4. Identify risk and protective factors for tobacco use among these AI adolescents, including positive cultural influences (e.g., strong AI ethnic identity, understanding of sacred tobacco use), negative cultural influences (e.g., historical trauma, exposure to tobacco advertising with stereotypical AI imagery), interpersonal influences (e.g., parents, peers), environmental influences (e.g., exposure to environmental tobacco smoke, smokefree policies at local casinos), and intrapersonal influences (e.g., perceived risks and benefits, depression). 5. In collaboration with our Community Advisory Board, develop recommendations for enhancing existing tobacco education programs to make them more culturally relevant and effective for AI adolescents. 6. Report the results of the survey and the recommendations back to the AI community, through schools, tribes, urban Indian organizations, and tobacco coalitions.