American Indian Tribal College Student's Knowledge, Attitudes and Beliefs about Recreational and Traditional Tobacco Use.

introductionAmerican Indians (AI) have the highest smoking rates of any racial/ethnic group in the U.S., in addition to low success rates of tobacco cessation. The substitution of commercial tobacco for traditional tobacco may have played a role in the prevalence rates of recreational tobacco use among AI. The present study explored the impact of tribal college students' knowledge, attitudes and beliefs about traditional tobacco use on their recreational cigarette smoking behaviors.

methodsMultiple methods were used to recruit participants attending a tribal college. A total of 101 AI tribal college students completed a demographic survey and participated in focus groups or individual interviews assessing traditional and recreational tobacco use.

resultsAI tribal college student's recreational smoking has an influence on various health behaviors, including poor eating habits, decreased physical activity, and elevated tobacco use in association with alcohol consumption. Differences between the use of and motivation behind smokeless tobacco and cigarette use were seen. In addition, participants reported differences between using tobacco for traditional purposes such as in ceremony or during prayer in comparison to recreational tobacco use. Conclusion: These findings highlight AI students' beliefs about recreational tobacco, smokeless tobacco, and traditional tobacco use. Differences related to behaviors associated with traditional tobacco use have important implications for future cessation efforts for AI smokers.