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A Qualitative Study about Creating Smoke-free Home Rules in American Indian and Alaska Native Households

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Abstract

Smoke-free homes can reduce exposure to secondhand smoke (SHS) and support smoking cessation. The current study seeks to understand perspectives, including barriers and facilitators, on smoke-free homes among five American Indian/Alaska Native (AI/AN) communities. Guided by a national work group of tribal partners, ten focus groups were conducted with AI/AN adult smokers and nonsmokers (n = 95) in Alaska, California, Michigan and Oklahoma, stratified by smoking status. The majority of participants lived in single unit detached homes (70.5%). Most of the nonsmokers had a smoke-free home rule (92.9%) and a majority of smokers did as well (64.7%). The most common reasons for smoke-free home rules were protecting children and grandchildren, including children with health problems. Challenges to a smoke-free home included weather and visitors who smoked, along with the inconvenience of going outside, the habit of smoking inside, the need to watch a young child, safety concerns, and smokers who break the rules. Respecting rules and respecting elders emerged as important themes. Traditional use of tobacco in the home was viewed as quite distinct from recreational or everyday use. Over half (58.2%) reported never using tobacco for ceremonial, prayer or traditional reasons in their homes. Given unique considerations for the adoption of smoke-free homes in AI/AN communities, particularly regarding the use of sacred tobacco for traditional, ceremonial, or medicinal purposes, it is important to learn which barriers and facilitators are similar to the general population and which may be unique to tribal communities in the U.S.

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Acknowledgements

Special thanks to Edy Rodewald, Jessica Voeller, and Stone Wallace for assistance with designing and/or conducting this research.

Funding

This work was supported by the National Cancer Institute’s State and Community Tobacco Control Research Initiative (Grant No. U01CA154282) and the California Tobacco Control Program, California Department of Public Health.

Author information

Authors and Affiliations

  1. Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA

    Michelle C. Kegler, Katherine Anderson, Lucja T. Bundy & Cam Escoffery

  2. Sault Ste Marie, USA

    Deana Knauf

  3. Cherokee Nation, 17675 S Muskogee, P. O. Box 948, Tahlequah, OK, 74464, USA

    June Halfacre

  4. United Indian Health Services: Potawot Health Village, 1600 Weeot Way, Arcata, CA, 95521, USA

    Andre Cramblit

  5. Black Hills Center for American Indian Health, 701 St. Joseph Street, Suite 204, Rapid City, SD, 57701, USA

    Patricia Henderson

  6. Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, USA

    Michelle C. Kegler

Authors
  1. Michelle C. Kegler
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  2. Katherine Anderson
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  3. Lucja T. Bundy
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  6. Cam Escoffery
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  7. Andre Cramblit
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  8. Patricia Henderson
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Corresponding author

Correspondence to Michelle C. Kegler.

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Conflict of interest

No financial disclosures or conflicts of interest were reported by the authors of this paper.

Ethical Approval

This study was approved by Emory University Institutional Review Board (IRB) (#IRB00087337) and the Cherokee Nation IRB. Other partners did not have or did not require local IRB approval.

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Written informed consent was obtained prior to the focus group discussions.

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Kegler, M.C., Anderson, K., Bundy, L.T. et al. A Qualitative Study about Creating Smoke-free Home Rules in American Indian and Alaska Native Households. J Community Health 44, 684–693 (2019). https://doi.org/10.1007/s10900-019-00666-1

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  • DOI: https://doi.org/10.1007/s10900-019-00666-1

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