Introduction American Indian (AI) adolescents have the highest prevalence of commercial tobacco use of any ethnic group in the United States. This study examines ethnic identity (EI), participation in cultural activities, and stressful life events (SLEs) as correlates of smoking and examines historical trauma (HT) as a mediator of these associations. Methods California AI youth (N= 969, ages 13–19, recruited from 49 tribal youth organizations and cultural activities in urban and reservation areas in California) completed a tobacco survey. Structural equation modeling was used to test a model examining HT as a potential mediator of the associations of EI, participation in cultural activities, and SLEs with cigarette smoking. Results Model fit was adequate. EI, participation in cultural activities, and SLEs predicted HT. HT mediated the associations of participation in cultural activities and SLEs with past-month smoking. Stronger EI predicted greater past-month smoking and this effect was mediated by greater HT. The direct effects from HT to both smoking outcomes were positive and the direct effect from EI to past-month smoking was negative. Conclusions HT is a risk factor for cigarette smoking both directly and in mediating the links of EI, cultural activities, and SLEs. More efforts are needed to help AI youth to process these thoughts and empower themselves to contribute to their own lives and those of their families and communities without resorting to unhealthy addictive behaviors such as commercial tobacco use.

INTRODUCTIONWe reviewed research literature on pro-tobacco marketing and anti-tobacco campaigns targeting eight vulnerable populations to determine key findings and research gaps. Results can inform tobacco policy and control efforts and the design of public education campaigns for these groups.METHODSFive journal databases in medicine, communication, and science, were used to identify 8875 peer-reviewed, original articles in English, published in the period 2004–2018. There were 144 articles that met inclusion criteria on pro-tobacco marketing or anti-tobacco campaigns aimed at eight US groups: women of reproductive age, racial/ethnic minority groups (African American, Hispanic/Latino, Asian/Pacific Islander and American Indian/Alaska Native), Lesbian/Gay/Bisexual/Transgender (LGBT) populations, groups with low socioeconomic status, rural/inner city residents, military/veterans, and people with mental health or medical co-morbidities. We summarized the number of articles for each population, type of tobacco, and pro-tobacco or anti-tobacco focus. Narrative summaries were organized by population and by pro-tobacco or anti-tobacco focus, with key strategies and gaps by group.RESULTSThere were more studies on pro-tobacco marketing rather than anti-tobacco campaigns, and on cigarettes rather than other tobacco products. Major gaps included studies on Asian Americans, American Indian/Alaska Natives, pregnant women, LGBT populations, and those with mental health or medical co-morbidities. Gaps related to tobacco products were found for hookah, snus, and pipe/roll-your-own tobacco in the pro-tobacco studies, and for all products except cigarettes in anti-tobacco studies. Common tobacco industry methods used were tailoring of product and package design and messages that were used to reach and appeal to different sociodemographic groups. Studies varied by research design making it difficult to compare results.CONCLUSIONSWe found major research gaps for specific groups and tobacco products. Public education campaigns need a stronger foundation in empirical studies focused on these populations. Research and practice would benefit from studies that permit comparisons across studies.

Cultural values can shape people’s attitudes toward substance use and influence their risk of experimentation with drugs. This article examines the relationships between cultural values (familism, respeto, and machismo), fatalism (a culturally encouraged personality disposition), and substance use among Hispanic adolescents. In 2005, cross-sectional data were collected from 1,616 Hispanic ninth grade students in Los Angeles. Each cultural value was associated with lifetime substance use; however, these relationships depended on the type of substance and gender. Our findings suggest that it might be useful to incorporate the cultural values and address the personality trait of fatalism in prevention programs for Hispanic adolescents. The study’s limitations are noted.

This study analyzed data from a large statewide sample of Native American adolescents throughout California to determine whether participation in cultural practices was associated with stronger ethnic identity. The Multigroup Ethnic Identity Measure (MEIM) scale was used to measure the ethnic identity of 945 Native American adolescents (416 male, 529 female) aged 13 – 19 across California. Respondents who participated in cultural activities including pow-wows, sweat lodge, drum group and roundhouse dance reported significantly higher Native American ethnic identity than their counterparts who did not take part in cultural activities. The association between cultural activities and ethnic identity was only significant among urban youth and not among reservation youth. Higher grades in school were associated with ethnic identity among females but not among males. Findings from this study show a strong association between cultural activities and traditional practices with tribal enculturation among Native American youth in California. Cultural-based practices to enhance Native identity could be useful to improve mental and behavioral health among Native American youth.

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