Tobacco, Health and the Law
Professor Vernellia R. Randall
The University of Dayton Law School
All other questions about the course
(both procedural or substantive)
should be sent to the
TWEN Discussion Group.
You are visitor number
since August 31, 1999.
|Spangler,-John-Given; Bell,-Ronny-Antonio; Dignan,-Mark-Boberg, Prevalence
and predictors of tobacco use among Lumbee Indian women in Robeson County,
North Carolina., 22 Journal o Community Health 115-25 (Apr.
ABSTRACT: Tobacco use among some Native American tribes is high
compared to the overall US population. Little is known, however,
about tobacco use among Native Americans in North Carolina, a state with
strong economic ties to tobacco. To assess the epidemiology of tobacco
use in this population, data from the North Carolina Native American Cervical
Cancer Project was reviewed. Nine hundred eighty-two Lumbee Indian
women in Robeson County provided general demographic information as well
as information on cancer risk knowledge, attitudes and behaviors during
the 5-year study. Women were selected from the community using a
random sample of 5200 persons from the tribal roll of approximately 40,000
persons. 20.6% of women were current smokeless tobacco users, while
23.7% were current smokers. Demographic and social support predictors
were unique for the different types of tobacco use. Cigarette smoking was
associated with younger age, higher education, excellent or good self-reported
health, having a recent physical exam, separated or divorced marital status,
low church participation, and alcohol consumption. Conversely, use
of smokeless tobacco was associated with older age, lower education level,
fair or poor self-reported health, widowed marital status, and having a
high number of friends. These data show a high prevalence of smokeless
tobacco use among women in this population, and a contrast in the predictors
of tobacco use by source. Intervention programs for tobacco use cessation
should be sensitive to these differences.
|Spangler,-John-G; Dignan,-Mark-B; Michielutte,-Robert, Correlates
of tobacco use among Native American women in western North Carolina,
87 American Journal of Public Health. 108-11 (Jan. 1997).
ABSTRACT: Objectives. This study examined correlates of tobacco
use among Cherokee women. Methods. Prevalence rates were analyzed
for 614 randomly selected Eastern Band Cherokee women. Results. The
prevalence rates for current smokeless tobacco use and smoking were 8%
and 39%, respectively. Smokeless tobacco use correlates included
lower education and having consulted an Indian healer. Smoking correlates
included younger age, alcohol use, no yearly physical exam, separated or
divorced marital status, and lack of friends or church participation.
Conclusions. Smoking rates among these women were slightly above national
rates. The association of smokeless tobacco use with having consulted
an Indian healer may help in understanding Cherokee women's smokeless tobacco
|Edward Lichtenstein,Promoting tobacco control
policies in Northwest Indian tribes, 85 American Journal of Public
Health 991994 (July 1995)
ABSTRACT: A culturally sensitive consultative process to facilitate
adoption by tribal councils of more effective tobacco control policies
was developed and evaluated. Thirty-nine North-west Indian tribes
were randomized to early intervention or late intervention conditions.
Early intervention tribes received a policy workbook and consultation by
means of meetings and telephone calls. Late intervention tribes were
assessed but received no assistance or encouragement regarding tobacco
use policies. The stringency of the policies was assessed via telephone
at baseline and after intervention. At postintervention there were
consistent, and generally statistically significant, differences in adoption
of more stringent and comprehensive smoking policies for early intervention
tribes compared with late intervention tribes. The intervention could
be used in other Indian settings.
|Roberta Hall, et. al., Tobacco use policies and practices
in diverse Indian settings, 19(3)
American Indian Culture and Research Journal 165- 180 (1995)
ABSTRACT: A description of the 1990-92 tobacco policies of four geographically
and culturally diverse American Indian settings. Data were obtained
from 39 Indian tribes in Washington, Idaho, and Oregon; 18 California Indian
health clinics; 8 Southwest schools attended by American Indians; and 6
Northeast urban Indian centers. Modest relationships were found between
observed indoor use of tobacco and leniency or absence of smoking policies,
and between the presence of no-smoking signs and stringency of indoor smoking
policies. This indicates a statistically significant link between
policies and practices and suggests that more stringent policies could
lead to healthier environments inside tribal buildings. One of the
most important findings is that Indian agencies are controlling personal
use of tobacco products within their sites.
Christina, Pegp, et. al., Tobacco, culture, and health among American Indians: a historical review, 19(2) American Indian Culture and Research Journal 143-164 (1995)
ABSTRACT: An investigation of possible historical and cultural
reasons for the high prevalence of contemporary tobacco use among North
American Indians. A literature review of tobacco use by American
Indians in precontact and colonial times shows that it was used extensively
for ceremonial, spiritual, social, political, and medicinal purposes. Centuries
of aboriginal sacred use, combined with increasing commercial use of tobacco
since the fur trade, may have formed a residual base of susceptibility
for later secular use. The high prevalence of tobacco use among most
American Indian social groups renders it probably the greatest current
threat to the health of American Indians. Tobacco's addictive qualities
place it on the same level as alcohol as a source of physical and psychological
dependency, a fact not always recognized in American Indian social contexts.
|Edward Lichtenstein, et.al., Effectiveness
of a Consultation Intervention to Promote Tobacco Control Policies in Northwest
Indian Tribes: Integrating Experimental Evaluation and Service Delivery,
24 American Journal of Community Psychology 639-55 (Oct. 1996)
ABSTRACT: A quasi-experimental replication of an intervention
for promoting tobacco control policies in Northwest Indian tribes is described
and the process of intervention including issues of collaboration among
research institutions and Indian organizations is discussed. The
policy intervention was evaluated using a pretest-posttest design wherein
20 tribes that had served as wait-list controls now received the intervention.
The intervention comprised a tribal representative attending a kickoff
orientation; follow-up visits to the tribes; distribution of tobacco policy
workbooks; and phone call consultations. Policy status and stringency
were assessed by means of telephone interviews with two key contacts per
tribe, and by a count of enacted policies. There were significant
pre-post changes in the primary outcome measure, a composite summary score
of tobacco policy stringency, and changes were also reflected in enacted
policies. The intervention effects observed were similar to those
found in the prior randomized trial and suggest a robust, disseminable
intervention. Much of the success achieved was attributed to the role of
an Indian organization in planning the project and implementing the intervention
and evaluation protocols.
|Fred Beauvais, Comparison of Drug
Use Rates for Reservation Indian, Non-Reservation Indian and Anglo Youth,
5(1) American Indian and Alaska Native Mental Health Research 13-31 (1992)
ABSTRACT: Data from the 1988-1990 American Drug & Alcohol Survey
(N = 150,000+ high school students each year) are used to compare rates
of drug use & involvement for 3 groups: American Indian (AI) youth
living on reservations, AI youth living off reservations, & Anglo youth.
A consistent pattern emerged, showing the lowest rates of use among Anglo
youth, higher rates among nonreservation AI youth, & the highest rates
among AI youth on reservations. Rates of tobacco & marijuana use also
are especially high for AI youth, & these youth show a pattern of earlier
initiation to drug use. Gender differences reveal slightly higher rates
of use for males. 8 Tables, 4 Figures, 14 References.
|F.D., Gilliland, et. al, Non-ceremonial
Tobacco Use among Southwestern Rural American Indians: the New Mexico American
Indian, 7(2) TOBACCO CONTROL 156-160 (SUM 1998).
Objectives-To ascertain non-ceremonial tobacco use among rural American
Indians in New Mexico (United States). Design-A geographically targeted
telephone survey. Setting-Rural New Mexico.