Prevalence of smoking among adult American Indian clinic users in northern California.

Background: The American Indian Cancer Control Project is a 5-year program funded by the National Cancer Institute designed to promote smoking cessation among adult Indians living in Northern California. This article describes the result of our smoking prevalence survey. Our Indian-specific program combines the physician's anti-smoking message with the efforts of Indian Community Health Representatives, who have access to the Indian patients' families and communities. The study sites consist of 4 urban and 14 rural American Indian clinics in Northern California. This article reports on the results of the smoking prevalence study conducted in the first phase of the project.

Methods: A total of 1,369 adult Northern California Indian patients at 18 Indian health clinics completed a questionnaire designed to assess smoking rates and patterns as well as health problems. Participants were adult American Indians attending 1 of 18 Indian health care clinics in Northern California during 1991. The participants included patients waiting for appointments with the clinic physician, dentist, and nurses.

Results: Forty percent (37.35, 42.64; 95% confidence interval) of the adult population in the sample smoke cigarettes; they hold lenient attitudes toward smoking and began smoking at an early age. These patients rate obesity as the No. 1 health problem, followed by high blood pressure, arthritis/rheumatism, and problems with alcohol. The survey also found that the highest smoking rate was among the Sioux (62%), a non-California tribe. This was followed by high rates among native California tribes: Maidu (46%), Pit River (39%), Pomo (38%), Hupa (37%), and Yurok (32%).