When comparing white people and Native Americans with similar income and education levels, whites smoke more cigarettes and are more nicotine dependent, according to a new study.
Multiple past studies have reported that, compared to white people, Native Americans have relatively high cigarette use. This has contributed to speculation that Native Americans might be inherently prone to smoking.
The new research in Drug and Alcohol Dependence shows, however, that after adjusting for differences in the income and education levels of the two groups, whites were more likely than Native Americans to use cigarettes daily, to consume larger numbers of cigarettes per month, and to be nicotine dependent.
In the adjusted comparisons, an estimated 15.3% of white people were daily cigarette users, compared to 13% of Native Americans; the percentage of people who consumed more than 300 cigarettes in the past month was 13.6 for whites, compared to 9.9 for Native Americans; and rates of nicotine dependence were 10.3% for whites, compared to 7.1% for Native Americans.
Researchers analyzed data from a survey of more than 4,000 Native Americans and 160,000 white people between 2013 and 2017. The US Substance Abuse and Mental Health Services Administration administered the survey, called the National Survey on Drug Use and Health.
Previous research has shown that the factors most strongly associated with cigarette use include lower income and educational attainment. Native Americans have the highest poverty rate of any major US ethnic group, but reports of their cigarette use levels typically have not adjusted for income and education. This can leave the mistaken impression that being Native American itself is linked to higher use.
“Tobacco use and tobacco-related disease and deaths are intertwined with the poverty facing many Native Americans,” says Teshia Arambula Solomon, a professor in the family and community medicine department and member of the Native American Research and Training Center at the University of Arizona.
“A critical need exists to increase and improve Native American tobacco prevention and treatment programs, while also addressing poverty,” she says.
“Despite lower cigarette use when income and education are considered, Native Americans are dying from cigarettes at a much higher rate than whites,” says Jamie Ritchey, adjunct professor of public health and director of the Tribal Epidemiology Center at the Inter Tribal Council of Arizona.
The study notes that the smoking-attributable death rate for Native Americans has been estimated at 414 per 100,000, which is substantially higher than the rate for whites—264 per 100,000.
“Beliefs such as Native Americans being distinctly prone to cigarette use are widespread but rarely tested,” says lead author James K. Cunningham, also a professor in the family and community medicine department and a member of the Native American Research and Training Center.
In 2016, the researchers debunked the belief that Native American have higher alcohol use when they found that alcohol use among Native Americans was comparable to or less than that of whites.
“The consequences of substance misuse are too serious to allow for myths and misinformation,” Cunningham says.
Source: University of Arizona