Bridging Research to Practice: Native American Stories of Becoming Smoke-free

  • Rodney C Haring


The use of recreational and commercial tobacco products (nonceremonial or sacred) in North American Indian populations is alarmingly high. A qualitative study based on grounded theory and guided by social work principles was used to discover the methods, strategies, and processes 16 members of the Seneca Nation used when they quit smoking. The study revealed that participants used a five-step process to quit smoking: becoming aware, internalizing realizations, considering health, “setting in mind” to quit, and reflecting. The theory emerging from the project was named “healthy mind-setting.” The results provide a framework for health care and service providers working with Seneca recreational tobacco users and may have significant relevance for indigenous populations worldwide.


Alexander, C. S., Allen, P., Crawford, M. A., & McCormick, L. K. (1999). Taking a first puff: Cigarette smoking experiences among ethnically diverse adolescents. Ethnicity & Health, 4, 245−257.

Centers for Disease Control and Prevention. (1998). American Indians and Alaska Natives and tobacco. Retrieved January 3, 2005, from tobacco/sgr/sgr_1998/sgr-min-fs-nat.htm

Centers for Disease Control and Prevention. (2004). Cigarette smoking among adults–United States. Morbidity and Mortality Weekly Report, 54, 1121−1124.

Easton, K. L., McComish, J. F., & Greenberg, R. (2000). Avoiding common pitfalls in qualitative data collection and transcription. Qualitative Health Research, 10, 703-707.

Gilliland, F. D., Mahler, R., & Davis, S. M. (1998). Non-ceremonial tobacco use among southwestern rural American Indians: The New Mexico American Indian Behavioural Risk Factor Survey. Tobacco Control, 7, 156−160.

Giovino, G. A. (1999). Epidemiology of tobacco use among U.S. adolescents. Nicotine & Tobacco Research, 1, S31−S40.

Glaser, B. G. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press. Hodge, F. S., & Casken, J. (1999). Characteristics of American Indian women cigarette smokers: Prevalence and cessation status. Health Care for Women

International, 20, 455−469.

Hodge, F. S., Cummings, S., Fredericks, L., Kipnis, P., Melody Williams, J. D., & Teehee, K. (1995). Prevalence of smoking among adult American Indian clinic users in northern California. Preventive Medicine, 24, 441−446.

Kegler, M., Cleaver, V., & Kingsley, B. (2000). The social context of experimenting with cigarettes: American Indian “start stories.” American Journal of Health Promotion, 15(2), 89−92.

Kerby, D. S., Brand, M. W., & John, R. (2003). Anger types and the use of cigarettes and smokeless tobacco among Native American adolescents. Preventive Medicine, 37, 485−491.

Lando, H. A., Johnson, K. M., Graham-Tomasi, R. P., McGovern, P. G., & Solberg, L. (1992). Urban Indians’ smoking patterns and interest in quitting. Public Health Reports, 107, 340−344.

LeMaster, P. L., Connell, C. M., Mitchell, C. M., & Manson, S. M. (2002). Tobacco use among American Indian adolescents: Protective and risk factors. Journal of Adolescent Health, 30, 426−432.

Mermelstein, R., & the Tobacco Control Network Writing Group. (1999). Explanations of ethnic and gender differences in youth smoking: A multi-site, qualitative investigation. Nicotine & Tobacco Research, 1, S91−S98.

Patton, M. Q. (1999). Enhancing the quality and credibility of qualitative analysis. Health Services Research, 34, 1189-1207.

Quintero, G., & Davis, S. (2002). Why do teens smoke? American Indian and Hispanic adolescents’ perspectives on functional values and addiction. Medical Anthropology Quarterly, 16, 439−457.

Spangler, J. G., Dignan, M. B., & Michielutte, R. (1997). Correlates of tobacco use among Native American women in western North Carolina. American Journal of Public Health, 87(1), 108−111.

Strauss, A., & Corbin, J. (1998). Basics of qualitative research (2nd ed.). Thousand Oaks, CA: Sage.

Struthers, R., Hodge, F. S., Geishert-Cantrell, B., & Casken, J. (2003). Community mapping: A tool in the fight against cigarette smoking on American Indian reservations. Policy, Politics, & Nursing Practice, 4, 295−302.

Substance Abuse and Mental Health Services Administration. (2003). Substance use among American Indians or Alaska Natives (Office of Applied Studies, NHSDA Report). Retrieved January 4, 2005, from AmIndians/AmIndians.htm

Substance Abuse and Mental Health Services Administration. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (Office of Applied Studies, NSDUH Series H-28, DHHS Publication No. SMA 05-4062). Rockville, MD: Author.

Thurmond, A. (2001). The point of triangulation. Journal of Nursing Scholarship, 33, 253-258.