Aboriginal life and death with tobacco
By Kenneth Williams
Windspeaker Staff Writer
Numerous health problems plague Aboriginal people: HIV and AIDS, diabetes, alcohol or other substance abuse, and suicide are just a few. The human cost is enormous as these problems do more than just claim the lives of the victims. There is often longer-term secondary damage done as a result of these illnesses. The break-up of families, the strain on health care resources, and the imperceptible cost to communities that lose productive members are all part of the fall out.
As bad as these health problems are, they are recognized and, to a greater or lesser extent, treated. But one of the most damaging health threats is one that is the most preventable, yet plagues Aboriginal people more than any other: tobacco addiction.
Aboriginal people in North America have the highest rate of smoking than any other population. A 15-year study in the United States showed that the American Indian and Alaskan Native adult population had about 40 per cent rate of tobacco use. This is the highest percentage when compared to the African-American, Asian, Hispanic and White adult populations.
The numbers are worse in Canada. According to a recent Health Canada survey, 57 per cent of Aboriginal adults and 54 per cent of Aboriginal teenagers are smokers. Worse yet, these numbers may indeed be higher. An analysis of the data indicated that Aboriginal people under-report smoking in surveys conducted by non-Aboriginal people. Just for comparison, the national rate of smoking is 31 per cent.
The Inuit had the highest percentage of smokers of any group in Canada with 72 per cent of the adult population using the product. Inuit youth (19 years or younger) reported a 71 per cent rate of smoking.
"It's a tragedy," said Garfield Mahood, executive director of the Ottawa based Non-Smokers' Rights Association. "It's another indication of the exploitation of another population in this country. Given that one out of every two users will be killed by the product, that means a lot preventable death."
Aboriginal people, however, have had a long term relationship with tobacco. It is a plant indigenous to North and South America. The tobacco used in commercial cigarettes today is a descendent from a species that the Spaniards took from the Arawak and Carib Indians of the Caribbean.
But the plant today bears little resemblance to its ancestor because it has been altered through 500 years of selective breeding to increase it's nicotine potency and leaf size.
Before the arrival of Columbus, Aboriginal people never used tobacco for recreational purposes. It was, and is, a powerful plant that was ingested—smoked or chewed—for strictly religious purposes. That quickly changed after European contact. The Spaniards saw the profitable potential of tobacco and began using the leaves and seeds for trade. Pretty soon newer strains were being created for milder flavor and bigger leaves. This was called 'trade tobacco.'
The European nations that settled eastern North America used tobacco for trading. Aboriginal people soon picked up the habit and started smoking trade tobacco recreationally. Tobacco never lost its religious significance, but the original strains used for ceremonies became rarer because they weren't traded. Inevitably, trade tobacco began to be used in religious ceremonies because it was easier to find. It is now common for commercial tobacco to be used at Aboriginal sacred ceremonies without a second thought to its lack of it spiritual significance.
The increased nicotine potency of trade tobacco also ensured that addiction to the product was much easier. Nicotine can be lethal on its own, but in a commercially-produced cigarette, it is but one of 4,700 chemical compounds found in the product, including 43 cancer-causing substances.
According to a Health Canada report called “Eating Smoke: A Review of Non-Traditional Use of Tobacco Among Aboriginal People”, smoking tobacco causes 85 per cent of all lung cancers and is linked to cancers of the mouth, throat, esophagus, pancreas, stomach, kidney, ureter, bladder and colon. It has also been linked to some cases of leukemia and 30 per cent of cervical cancer cases in women. In total, about 30 per cent of all cancer deaths are related to smoking cigarettes.
But that's not all. Smokers are at a higher risk of suffering cardiovascular diseases, such as stroke, sudden death, heart attack, peripheral vascular disease and aortic aneurysm. Smoking is also the leading cause of pulmonary (lung-related) illnesses due to respiratory infection, pneumonia, emphysema, chronic bronchitis and influenza.
According to Health Canada, Aboriginal men living on reserves have a 40 per cent higher death rate from stroke than other Canadians. Aboriginal women on reserves have a 62 per cent higher rate of heart disease. Lung cancer is a major cause of death among Inuit people, with Inuit women having one of the highest rates in the world. All of these can be traced to smoking.
But smokers aren't the only ones who suffer.
Environmental tobacco smoke, otherwise known as second-hand smoke, is just as dangerous. The Environmental Protection Agency in the United States has declared environmental tobacco smoke a class "A" carcinogen, which means it causes cancer in humans.
Non-smokers who live with smokers have a 30 per cent higher risk of death from heart attack and lung cancer. The longer the non-smoker is exposed to smoke, the higher the risk.
A recent study indicated that Aboriginal babies died from sudden infant death syndrome at a rate three-times higher than the Canadian average. The Canadian average of sudden infant death syndrome is 0.7 per 1,000 births, whereas the Aboriginal average is 2.5 per 1,000 births. According to Dr. Michael Moffat, a pediatrician at the University of Manitoba and a researcher working on the study, smoking was a major factor in this statistic.
Lead researcher, Dr. Elske Hidles-Ripstein, found that Aboriginal mothers were more than twice as likely as non-Aboriginal mothers to smoke during their pregnancies. Her findings indicated that 53 per cent of Aboriginal mothers smoked while pregnant compared to just 26 per cent of non-Aboriginal mothers.
In the April 1996 issue of Pediatrics magazine, a study examined the relationship between women smoking during pregnancy and the rate of mental impairment in their babies. The researchers from Emory University, the U.S. Centres for Disease Control and Prevention, and Battelle Centres for Public Health, Research and Evaluation discovered that women who smoked were 50 per cent more likely to have a child with an IQ of 70 or less than non-smoking mothers, higher rates of spontaneous abortions, stillbirths, lower birth weight babies and complications during delivery.
It has also been discovered that nursing mothers can pass the harmful chemicals from tobacco to the infant even though the baby has not been directly exposed to second-hand smoke. Evidence also shows that second-hand smoke can cause developmental delays and behavioral problems in children.
Young women are picking up the smoking habit faster than any other segment of the population. This trend has meant that lung cancer is now the leading cause of cancer death for women, surpassing breast cancer. Part of the reason for young women smoking more is their mistaken belief that it can be used to control their weight.
Two studies in Canada and the United States indicated that most smokers start before the age of 20. According to a 1994 Health Canada study, smoking will be responsible for premature death (that is, death before the age of 70) in 55 per cent of young men and 51 per cent of young women now aged 15 if they continue to smoke.
"It's the number one preventable cause of morbidity and mortality in the entire population," said Mahood. "There's nothing else out there that is going to kill one out of every two users."
There is no data available on why Aboriginal people are more prone to smoking but some studies have shown a correlation between poverty, high unemployment, low income and high rates of smoking. Poverty is definitely a problem on most reserves in Canada, and is a problem for most off-reserve Aboriginal people as well.
There are several anti-smoking and non-smoking organizations and health groups that are trying to educate people about the dangers of tobacco. But it's tough convincing Aboriginal people about the dangers of tobacco when they see it as a sacred plant necessary for traditional ceremonies.
The Traditional Native American Tobacco Seed Bank and Education Program at the University of New Mexico is making an attempt to maintain the traditional-ceremonial use of tobacco while educating people about the dangers of its misuse.
Joseph Winter runs the program, cultivates seeds and plants of traditional tobacco and distributes them free to Aboriginal people, tribes and organizations that need them for sacred ceremonies. He also issues a pamphlet that outlines the proper use of tobacco. It states: Under no circumstances should you smoke, chew, or otherwise ingest tobacco, for non-traditional so-called "pleasure." This applies to Native Americans as well as non-Native Americans.
The Pauktuutit Inuit Women's Association started a non-smoking campaign called Breathing Easy. According to statistics the organization has compiled, 30 per cent of Nunavik (northern Quebec) deaths are caused by tobacco use.
Health Canada has outlined a 12-point action list to educate Aboriginal people about tobacco use, based on the World Health Organization plan for tobacco control.
There is a reason for concern. If 50 per cent of smokers die prematurely, and about 50 per cent of Aboriginal Canadians smoke, then 25 per cent of the total Aboriginal population is destined to die prematurely. But what does that mean in real numbers?
The First Nations population in Canada is about 600,000. According to the statistics, about one-quarter of them, or 150,000 First Nations people, will die prematurely because of tobacco-related illnesses. The economic, social, cultural, political and health care consequences are staggering.