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Advancing smoke-free policy adoption on the Navajo Nation
  1. Patricia Nez Henderson1,
  2. April Roeseler2,
  3. Gregg Moor3,
  4. Hershel W Clark1,
  5. Alfred Yazzie1,
  6. Priscilla Nez1,
  7. Chantal Nez1,
  8. Samantha Sabo4,
  9. Scott J Leischow5
  1. 1Black Hills Center for American Indian Health, Rapid City, South Dakota, USA
  2. 2California Tobacco Control Program, California Department of Public Health, Sacramento, California, USA
  3. 3InSource, Coquitlam, British Columbia, Canada
  4. 4Department of Health Promotions Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
  5. 5Mayo Clinic Arizona, Scottsdale, Arizona, USA
  1. Correspondence to Dr Patricia Nez Henderson, Black Hills Center for American Indian Health, 701 St Joseph Street, Suite 204, Rapid City, SD 57701, USA; pnhenderson{at}


Background Comprehensive smoke-free laws are effective at protecting non-smokers and reducing tobacco use, yet they are not widely adopted by tribal governments.

Methods A series of smoke-free policy initiatives on the Navajo Nation, beginning in 2008, were reviewed to identify key issues, successes and setbacks.

Results It has been essential that proposed policies acknowledge the Navajo people's spiritual use of nát'oh, a sacred plant used for gift-giving, medicinal purposes and traditional ceremonies, while simultaneously discouraging a secular use of commercial tobacco. Concern that smoke-free policies economically harm tribal casinos has been a major barrier to broad implementation of comprehensive smoke-free laws in Navajo Nation.

Conclusions It is necessary for tobacco control researchers and advocates to build relationships with tribal leaders and casino management in order to develop the business case that will take comprehensive smoke-free policies to scale throughout tribal lands.

  • Disparities
  • Priority/special populations
  • Public policy
  • Secondhand smoke

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