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Taking the time to develop relationships with tribal leaders will be key to helping reduce smoking rates on reservations across the U.S., says Patricia Nez Henderson, who has been appointed to the Interagency Committee on Smoking and Health.

Henderson, who is vice president of the Black Hills Center for American Indian Health and a Navajo Nation tribal member, has been appointed by the U.S. Secretary of Health and Human Services to serve a four-year term on the committee.

The committee will raise awareness of the issue of smoking and health by sharing information and collaborating across Department of Health and Human Services agencies, and with other federal agencies and public health organizations, Henderson said.

Smoking rates have declined in the U.S. for the general population during the past five years, but they are still high in most Native communities, Henderson said. According to a recent report by the Centers for Disease Control and Prevention, about 19 percent of the general population smokes, but that rate jumps to 39 percent for Native communities.

“That results in an increase in lung cancer, cardiovascular disease and asthma,” Henderson said.

Secondhand smoke is one of the biggest problems right now, she said.

One of the best ways to combat the problem is through education and forming strong relationships with tribal communities to assist them as they implement smoke-free policies on reservations.

The Black Hills Center for American Indian Health in Rapid City has studied the rates of smoking among the Lakota people, Henderson said, and smoke-free policies in public settings and the workplace is one of the most effective ways to reduce the rates.

Traditional ceremonies continue to include tobacco as well, she said. Ceremonial tobacco, for example, is still used in many traditional tribal ceremonies.

“The role of ceremonial tobacco is an issue,” she said. “We have to address it in a way that’s culturally appropriate. Tribes are hesitant to have people from the outside dictating policy. The relationships get strained, but you have to be persistent.”

It’s not enough to simply say that tobacco isn’t good for health, she said.

“It has to be the science and cultural knowledge,” she said. “They have to go together.”

Need for funding, more research 

Part of her work on the Interagency Committee will be helping people understand that there is a disparity between the general population and Native populations in smoking rates, and that there’s a need for funding and a need for research.

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“As a Native scientist, for me, it’s very important for people to understand why the rates of smoking on reservations are so high and what we can do to address these issues,” she said.

She has worked one-on-one with traditional healers to find alternatives. It has taken a decade of relationship-building with tribal leaders to pass along the concerns and effect change. She was encouraged when the Navajo Nation in Arizona has passed a smoke-free policy.

“That was huge,” she said.

Henderson received her master’s in Public Health and Medicine from Yale University and immediately went in to public health work.

“I saw that there’s a lot more preventative work that can be done in communities,” she said, with tobacco use being just one.

She hopes that the appointment to the Interagency Committee will help her be more effective in her work.

“I want to bring an increased awareness about not only the high smoking rates in Indian country, and that there are challenges to this, but that by working together we can address it,” she said.

In addition to this new appointment, Henderson has served as a panel member on the 2008 update of the Public Health Service Clinical Practice Guideline “Treating Tobacco Use and Dependence,” and the Federal Drug Administration Tobacco Products Scientific Advisory Committee.

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